Basic Information
| Provider Information | |||||||||
| NPI: | 1194948265 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | BODNAR | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2797 NC HIGHWAY 55 | ||||||||
| Address2: | MINUTE CLINIC DIAGNOSTIC OF NORTH CAROLINA | ||||||||
| City: | CARY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8663892727 | ||||||||
| FaxNumber: | 4016529787 | ||||||||
| Practice Location | |||||||||
| Address1: | 2797 NC HIGHWAY 55 | ||||||||
| Address2: | MINUTE CLINIC DIAGNOSTIC OF NORTH CAROLINA | ||||||||
| City: | CARY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27519 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8663892727 | ||||||||
| FaxNumber: | 4016529787 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2007 | ||||||||
| LastUpdateDate: | 05/01/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | F330138 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 5007558 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.