MISS BONNIE L SERVAGE (NPI# 1093718066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093718066 |
| Entity Type | Individual |
| Full Name | MISS BONNIE L SERVAGE |
| Credential | ANP |
| Practice Address |
53-59 Public Sq Ste 301 Watertown NY 13601-2674 |
| Practice Telephone | 3157822141 |
| Practice Fax Number | 3157825123 |
| Mailing Telephone | 3157822141 |
| Mailing Fax Number | 3157825123 |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2007-10-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
F303309 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02331175 | 05 | |
| NY | GHI | 7599474 | 01 |
| Street Address |
53-59 PUBLIC SQ STE 301 |
| City | WATERTOWN |
| State | NY |
| Zip Code | 13601-2674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225031255 | Collins F Kellogg Jr. | Internal Medicine | 53-59 Public Sq, Ste 301, Watertown, NY 13601-2674 | 2005-05-23 |
| 1730370974 | Watertown Audiology PC | Audiologist-Hearing Aid Fitter | 53-59 Public Sq, Suite 100, Watertown, NY 13601-2674 | 2007-08-05 |
| 1306065289 | Sarah R Sugden | Audiologist | 53-59 Public Sq, Suite 100, Watertown, NY 13601-2674 | 2007-04-25 |
| 1174525547 | Internal Medicine of Northern New York | Internal Medicine | 53-59 Public Sq, Suite 201, Watertown, NY 13601 | 2005-08-15 |
| 1720080187 | Frank Rhode | Internal Medicine | 53-59 Public Sq, Suite 201, Watertown, NY 13601-2674 | 2005-08-15 |
| 1518960590 | Laverne R Vandewall | Internal Medicine | 53-59 Public Sq, Ste 301, Watertown, NY 13601-2674 | 2005-05-24 |
| 1265435234 | Julie M Lapointe | Internal Medicine | 53-59 Public Sq, Ste 301, Watertown, NY 13601-2674 | 2005-05-24 |
| 1598768574 | Nancy J Spicer | Nurse Practitioner | 53-59 Public Sq, Ste 301, Watertown, NY 13601-2674 | 2005-05-24 |
| 1447253471 | Ann M Lepine | Nurse Practitioner | 53-59 Public Sq, Ste 301, Watertown, NY 13601-2674 | 2005-05-23 |
| 1811990856 | Kathryn A Kolton | Nurse Practitioner | 53-59 Public Sq, Ste 301, Watertown, NY 13601-2674 | 2005-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801414156 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 122 Court Street, Empsall Bldg, Room 212, Watertown, NY 13601 | 2020-07-13 |
| 1083231377 | Katherine Anne Cahill | Counselor | 22679 Duffy Road, Watertown, NY 13601 | 2020-07-02 |
| 1851855431 | Hanna Kearney | Physical Therapist | 20053 Summit View Blvd Ste 2, Watertown, NY 13601 | 2019-01-28 |
| 1578039905 | North Country Counseling Services LLC | Counselor | 210 Court St. Suite 4, Watertown, NY 13601 | 2018-10-24 |
| 1073004388 | Megan Anna O'brien | Counselor | 221 S Rutland Street, Watertown, NY 13601 | 2018-05-22 |
| 1558860536 | Kimberly Lynne Amelio | Specialist | 24850 Hinds Rd, Watertown, NY 13601 | 2018-02-06 |
| 1952840050 | Alberto Gonzalez | Social Worker | 211 Jb Wise Plaza, Watertown, NY 13601 | 2017-02-22 |
| 1073967386 | Amanda Pisarski | Licensed Practical Nurse | 26713 Nys Rte 12, Watertown, NY 13601 | 2016-04-22 |
| 1396137709 | Daniel Ernest Morgan | Neuromusculoskeletal Medicine & OMM | 21101 Ny-12f, Building 2, Suite 7, Watertown, NY 13601 | 2015-02-21 |
| 1568868131 | Megan E. Zamora | Dental Hygienist | 14652-b Cedar Way, Watertown, NY 13601 | 2014-11-10 |
| Find all providers in zip 13601 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346322450 | Jane M Prendergast | Nurse Practitioner | 218 Stone St Fl 2, Community Clinic of Jefferson County, Watertown, NY 13601-3211 | 2006-10-19 |
| 1699759100 | Dawn Lillian Scott | Nurse Practitioner | 1511 Washington St, Suite 7, Watertown, NY 13601-9314 | 2005-11-30 |
| 1043202005 | Linda M Moser | Nurse Practitioner | 53 Public Sq, Suite 201, Watertown, NY 13601-2674 | 2005-08-16 |
| 1811431877 | Megan Merkel | Nurse Practitioner | 401 9th Ave Nw, Watertown, SD 57201-1548 | 2016-12-10 |
| 1003203456 | Jacklyn Ann Karli | Nurse Practitioner | 401 9th Ave Nw, Watertown, SD 57201-1548 | 2015-04-23 |
| 1043634652 | Np Adult Healthcare Pllc | Nurse Practitioner | 1511 Washington St, Suite 7, Watertown, NY 13601-9314 | 2014-02-18 |
| 1386899359 | Maureen A Skehill | Nurse Practitioner | 485 Arsenal St, Internal Medicine, Watertown, MA 02472-5091 | 2008-11-18 |
| 1922259373 | Debra R Marsala | Nurse Practitioner | 160 Stone St, Watertown, NY 13601-3250 | 2008-10-03 |
| 1669654414 | Mary Dawley | Nurse Practitioner | 830 Washington St, Watertown, NY 13601-4034 | 2007-12-04 |
| 1831102748 | Marcy B Mills | Nurse Practitioner | 1575 Washington St, Watertown, NY 13601-9367 | 2006-08-14 |
| Find all providers in WATERTOWN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.