MS. HOLLY L BONAVIA (NPI# 1942219647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942219647 |
| Entity Type | Individual |
| Full Name | MS. HOLLY L BONAVIA |
| Other Name | HOLLY RICE |
| Credential | PA-C |
| Practice Address |
1575 N Rivercenter Dr #124 Milwaukee WI 53212-3965 |
| Mailing Address |
3301 W Forest Home Ave Milwaukee WI 53215-2843 |
| Practice Telephone | 4142838444 |
| Practice Fax Number | 4142838450 |
| Mailing Telephone | 4146476326 |
| Mailing Fax Number | 4146718860 |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2019-12-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 3124-28 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363A00000X | Physician Assistant | 753-023 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42951300 | 05 |
| Street Address |
1575 N RIVERCENTER DR #124 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53212-3965 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427032960 | Debesh Chandra Mazumdar | Internal Medicine | 1575 N Rivercenter Dr, Suite 104, Milwaukee, WI 53212-3978 | 2005-11-29 |
| 1740817204 | Haille Damaris Newell | Massage Therapist | 1575 N Rivercenter Dr, Milwaukee, WI 53212-3978 | 2020-03-25 |
| 1073143921 | Sarah C Flynn | Pharmacist | 1575 N Rivercenter Dr, Milwaukee, WI 53212-3978 | 2020-01-20 |
| 1639645740 | Taylor Catherine Villwock | Nurse Practitioner | 1575 N Rivercenter Dr, Milwaukee, WI 53212-3978 | 2018-10-16 |
| 1265968655 | Crystal E Rayon | Family Medicine | 1575 N Rivercenter Dr, Milwaukee, WI 53212-3978 | 2017-05-04 |
| 1487198008 | Christine Tjernagel | Physical Therapist | 1575 N Rivercenter Dr, Rehabilitation/therapy Dept, Milwaukee, WI 53212-3978 | 2016-12-16 |
| 1891159612 | Shane Breeze-baldauf | Family Medicine | 1575 N Rivercenter Dr, Milwaukee, WI 53212 | 2016-04-07 |
| 1487029351 | Aurora Pharmacy | Pharmacy | 1575 N Rivercenter Dr, Milwaukee, WI 53212-3978 | 2015-12-03 |
| 1013354661 | Michael Holyoke | Student in an Organized Health Care Education/Training Program | 1575 N Rivercenter Dr, Milwaukee, WI 53212-3978 | 2013-05-22 |
| 1477802148 | Razieh Hadian Jazi | Family Medicine | 1575 N Rivercenter Dr, #160, Milwaukee, WI 53212-3978 | 2012-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609481001 | Beth Leanna | Counselor | Benedict Center 1849 N Dr. Marin Luther King Dr., Suite 101, Milwaukee, WI 53212 | 2020-09-11 |
| 1326683749 | A.b.d.h. Counseling Services LLC | Clinic/Center | 518 E Concordia Avenue, Milwaukee, WI 53212 | 2019-11-08 |
| 1467095703 | Ifrah Hameed | Psychologist | 1849 N Doctor M.l.k. Jr Dr# 101, Milwaukee, WI 53212 | 2019-10-18 |
| 1386293330 | Rachel Mae Nelson Bagha | Student in an Organized Health Care Education/Training Program | 1849 N Doctor M.l.k. Jr Dr #101, Milwaukee, WI 53212 | 2019-09-11 |
| 1164085205 | Mary Sue Daase Bowen | Counselor | 2821 N 4th Street, Milwaukee, WI 53212 | 2019-04-15 |
| 1649733189 | Stacey King | Counselor | Rivershore Comprehensive Treatment Facility, 3703 N Richards St, Milwaukee Wi, Milwaukee, WI 53212 | 2019-04-11 |
| 1710447701 | Scott William Stauder | Student in an Organized Health Care Education/Training Program | 1121 E. North Ave., Milwaukee, WI 53212 | 2019-03-25 |
| 1821561168 | Lydia Ann Mendez | Counselor | 3703 N Richards St, Milwaukee, WI 53212 | 2019-01-09 |
| 1851863302 | Glen Victor Fleming | Counselor | 2821 North 4th Street Suite 210, Milwaukee, WI 53212 | 2018-12-21 |
| 1093285140 | Megan Marie Volp | Advanced Practice Midwife | 2555 N Doctor M.l.k. Jr Dr, Milwaukee, WI 53212 | 2018-12-03 |
| Find all providers in zip 53212 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386257194 | Harrison R Pham | Physician Assistant | 214 E Florida St Apt 526, Milwaukee, WI 53204-1657 | 2020-08-31 |
| 1942824602 | Rebecca Frances Hasler | Physician Assistant | 2368 N Humboldt Blvd, Milwaukee, WI 53212-3524 | 2020-05-28 |
| 1194355784 | Ashley Bishop Henning | Physician Assistant | 2350 N Lake Dr Ste 404, Milwaukee, WI 53211-4528 | 2020-01-22 |
| 1902457575 | Kathryn Kasper | Physician Assistant | 2408 N Buffum St, Milwaukee, WI 53212-2902 | 2019-09-25 |
| 1972151314 | Kelly J Meyer | Physician Assistant | 2900 W Oklahoma Ave Ste 414, Milwaukee, WI 53215-4330 | 2019-08-28 |
| 1659923795 | Mikayla Preissner | Physician Assistant | 788 N Jefferson St Ste 401, Milwaukee, WI 53202-3718 | 2019-07-09 |
| 1245892124 | Emily Mason | Physician Assistant | 2901 W Kk River Pkwy Ste 507, Milwaukee, WI 53215-3660 | 2019-07-01 |
| 1124513528 | Kirby Kristine Hancock | Physician Assistant | 2350 N Lake Dr Ste 302, Milwaukee, WI 53211-4528 | 2018-06-27 |
| 1548785785 | Anne Gustavson | Physician Assistant | 5500 W Brown Deer Rd Ste 400, Milwaukee, WI 53223-2265 | 2017-08-09 |
| 1205359973 | Christina Marie Rende | Physician Assistant | 2350 N Lake Dr Ste 206, Milwaukee, WI 53211-4528 | 2017-07-24 |
| Find all providers in MILWAUKEE | ||||
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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.