Provider Demographics
NPI:1023485034
Name:KONASEK, BONNIE J (CRNP)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:J
Last Name:KONASEK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:J
Other - Last Name:EATON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, FNP-BC
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:MC A410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0858
Mailing Address - Country:US
Mailing Address - Phone:800-243-1455
Mailing Address - Fax:
Practice Address - Street 1:2501 N 3RD ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-1904
Practice Address - Country:US
Practice Address - Phone:717-782-4734
Practice Address - Fax:717-782-4727
Is Sole Proprietor?:No
Enumeration Date:2015-08-25
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV75258363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner