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Contact Information

SHAWN P BONILLA, NP
821 E VETERANS MEMORIAL HWY
BLANCHARD, OK73010-9215
 Phone: 405-659-5656
 Fax: 405-701-5421
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acute Care

363LA2100X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for SHAWN P BONILLA · (Male)

NPI Number 1134213978
Status Active
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 10/03/2006
Last updated 03/24/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • OK License # ROO68442
  • OK Medicaid 200226680A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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