Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sally Diane Bonham, BSN, MSN, FNP, IBCLC

Individual provider Lactation Consultant (Registered Nurse) · NPI 1811750078

Sally Diane Bonham, BSN, MSN, FNP, IBCLC is a Nurse Practitioner in Waco, Texas. Qualified in 2023, 3 years ago. Practices with Mark Malone MD PA, a 101-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
3
Licensed in
TX
In the registry since
2024
Specialties on file
2
What do these letters mean?
BSN — Bachelor of Science in Nursing
A four-year nursing degree.
MSN — Master of Science in Nursing
A graduate nursing degree, usually held alongside an advanced practice licence.
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

See every abbreviation used in this directory →

Practice location Address checks out

3500 Hillcrest Dr Ste 1
Waco, TX 76708-3144
Phone: (254) 741-6641
Fax: (257) 453-7469
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2000 S Mays St Ste 201, Round Rock, TX 78664-7580 — (512) 244-4272

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 1182184 (TX)
Lactation Consultant (Registered Nurse) Taxonomy 163WL0100X · Licence 638280 (TX)

Record details

NPI number1811750078
Entity typeIndividual (Type 1)
GenderFemale
Credentials BSN , MSN , FNP , IBCLC
Sole proprietorNo
NPI enumeratedJanuary 31, 2024
Last updated in NPPESOctober 29, 2025
Certification dateOctober 29, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Mark Malone Md Pa — 101 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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