| NPI | 1831875426 |
|---|---|
| Former Name | SHELBY ANN BONNEMIER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 3194) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363A00000X Physician Assistant (Licence: IA 129662) | |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2025-03-13 |