Provider Demographics
NPI:1992695498
Name:BONNOT, ASHLEY MARIE (FNP-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:BONNOT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 E HARRISON CT
Mailing Address - Street 2:
Mailing Address - City:ELLETTSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47429-2057
Mailing Address - Country:US
Mailing Address - Phone:330-704-4876
Mailing Address - Fax:
Practice Address - Street 1:1310 W BLOOMFIELD RD STE C
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-2001
Practice Address - Country:US
Practice Address - Phone:812-334-2772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71016802A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily