Provider Demographics
NPI:1073749610
Name:OBOIS, BONNIE L (RN)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:L
Last Name:OBOIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 S MAIN ST
Mailing Address - Street 2:SUITE G PO BOX 1006
Mailing Address - City:ADAMS
Mailing Address - State:WI
Mailing Address - Zip Code:53910-9820
Mailing Address - Country:US
Mailing Address - Phone:608-339-3151
Mailing Address - Fax:608-339-9619
Practice Address - Street 1:139 S MAIN ST
Practice Address - Street 2:SUITE G
Practice Address - City:ADAMS
Practice Address - State:WI
Practice Address - Zip Code:53910-9820
Practice Address - Country:US
Practice Address - Phone:608-339-3151
Practice Address - Fax:608-339-9619
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI113935-030163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care