Doctor Name: | BONNIE ECK |
NPI Number: | 1942270673 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | R0821904 |
Business Practice Address: | 123 4th St Nw Bagley, MN - 566218306 |
Business Phone Number: | 2186942384 |
Business Fax Number: | 2186946687 |
Mailing Address: | 123 4th St Nw, BAGLEY |
State: | MN |
Postal Code: | 566218306 |
Phone Number: | 2186942384 |
Fax Number: | 2186946687 |
NPI Enumeration Date: | 01/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R0821904 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |