Provider Demographics
NPI:1437552460
Name:BONNER, JUANITA LYNETTE (PHARMD, RPH, BCMTMS)
Entity type:Individual
Prefix:DR
First Name:JUANITA
Middle Name:LYNETTE
Last Name:BONNER
Suffix:
Gender:F
Credentials:PHARMD, RPH, BCMTMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 24 RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1239
Mailing Address - Country:US
Mailing Address - Phone:970-244-8110
Mailing Address - Fax:970-244-8112
Practice Address - Street 1:630 24 RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1239
Practice Address - Country:US
Practice Address - Phone:970-244-8110
Practice Address - Fax:970-844-8112
Is Sole Proprietor?:No
Enumeration Date:2014-10-05
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6153183500000X
WY3680183500000X
COPHA.0020755183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist