Provider Demographics
NPI:1427252709
Name:BONNER, KRISTA M (ARNP)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:M
Last Name:BONNER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MANNING DR
Mailing Address - Street 2:ROOM 4018, UNC HOSPITALS
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-4220
Mailing Address - Country:US
Mailing Address - Phone:919-966-5063
Mailing Address - Fax:919-966-3034
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:ROOM 4018, UNC HOSPITALS
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-966-5063
Practice Address - Fax:919-966-3034
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004869363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC244395OtherREGISTERED NURSE