IndividualActive
Bonita Martin, NP
NPI 1053950113 · Gerontology Nurse Practitioner · De Queen, AR
Provider details
- NPI number
- 1053950113
- Entity type
- Individual
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- License
- 123723 (AR)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
500 E Collin Raye Dr
De Queen, AR 71832-8048
Phone: (870) 584-1055
Approximate (ZIP-level) locationGet directions
Mailing address
358 Bridge Creek Rd
Horatio, AR 71842-9000
Registry dates
- Enumerated
- 2020-01-06
- Last updated
- 2020-02-11
- Certified
- 2020-02-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.