LISA DIANE BONHAM LPN
NPI 1568856771
Licensed Practical Nurse in Ardmore, OK

Q: What is the provider's specialty?

The provider's specialty is Licensed Practical Nurse with taxonomy code 164W00000X.

Active since March 25, 2015

2530 S COMMERCE ST, ARDMORE, OK 73401(580) 223-5070(580) 226-3569 Get Directions Write a Review

NPPES record last updated: March 25, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Lisa Diane Bonham Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LISA DIANE BONHAM LPN (NPI 1568856771) is an individual licensed practical nurse in Ardmore, Oklahoma, licensed in Oklahoma (L0029404) and active in the NPI registry since March 2015.

NPPES Registry Identity

NPI1568856771

Entity TypeIndividualFemale

Primary Taxonomy164W00000X

Provider Legal NameLISA DIANE BONHAMCredential: LPN

Location Address2530 S COMMERCE STArdmore, OK 73401-5519

Mailing Address2530 S Commerce StArdmore, OK 73401-5519 · (580) 223-5070 · Fax (580) 226-3569

Phone(580) 223-5070

Fax(580) 226-3569

Sole ProprietorNo

Enumeration DateMarch 25, 2015

✔ NPI 1568856771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers

Taxonomy Code164W00000X

License✔ Licensed in OK · L0029404

Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

2530 S COMMERCE ST, Ardmore, OK 73401

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