Doctor Name: | MRS. DENISE BONNETT |
NPI Number: | 1477695708 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN,BC |
License Number: | 80108-30 |
Business Practice Address: | 1 W Lincoln St Box 661 Waupun, WI - 539631949 |
Business Phone Number: | 9203246235 |
Business Fax Number: | |
Mailing Address: | 103 Wilson St, ROSENDALE |
State: | WI |
Postal Code: | 549749759 |
Phone Number: | 9208725053 |
Fax Number: | |
NPI Enumeration Date: | 02/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 80108-30 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |