Bonny Anne Wallace

NPI #1043972953 in Hilo, Hawaii

Provider Information

NPI Number: 1043972953
Entity Type: Individual
Name: Bonny Anne Wallace
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Community Health Worker
Enumeration Date: Oct 7, 2021
Last Updated: Oct 7, 2021

Practice Location

Address: 167 AIPUNI ST
City: Hilo
State: Hawaii
ZIP Code: 96720-1803
Phone: (808) 959-5855

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Health Worker	172V00000X	Primary

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