Sally Diane Bonham, BSN, MSN, FNP, IBCLC

Nurse practitioner in Waco, Texas · NPI 1811750078

Sally Bonham is one of 209 nurse practitioners practicing in Waco, Texas. Sally Bonham practices with Mark Malone MD PA.

Registry record (NPPES)

NPI
1811750078
Type
Type 1 · Individual
Primary taxonomy
Nurse Practitioner, Family · 363LF0000X
Address on file
3500 Hillcrest Dr Ste 1
Waco, TX 76708-3144
(254) 741-6641
Enumerated
Jan 31, 2024
Record last updated
Oct 29, 2025
License states listed
TX

Medicare (CMS)

Enrollment
Medicare-enrolled in TX
Nurse Practitioner
Revalidation due
No date set by CMS

The registry stops here. NPivot keeps going.

  • Part D prescribing
  • Procedure volumes by CPT code
  • Group affiliations and colleagues
  • Full enrollment history
See the full profile free Free account. No card, no call.

Practice locations

More nurse practitioners in Waco

Updated August 2026. Practice locations and specialty come from the CMS Doctors and Clinicians file, the registry record from NPPES, and enrollment from CMS Medicare enrollment files. NPI records are corrected at the source, through NPPES.