Provider Demographics
NPI:1306985841
Name:HALDERSON, BONNIE JEAN (ARNP)
Entity type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:JEAN
Last Name:HALDERSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:BONNIE
Other - Middle Name:JEAN
Other - Last Name:HALDERSON-RITTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:203 E PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-2953
Mailing Address - Country:US
Mailing Address - Phone:203-312-5370
Mailing Address - Fax:
Practice Address - Street 1:33 ONE HALF PEMBROKE ROAD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811
Practice Address - Country:US
Practice Address - Phone:203-312-5370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 696592363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health