Provider Demographics
NPI:1215018338
Name:DAWSON, BONNIE JANE (RN, MSN, CNS)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:JANE
Last Name:DAWSON
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Gender:F
Credentials:RN, MSN, CNS
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Other - First Name:
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Mailing Address - Street 1:1 VETERANS DR
Mailing Address - Street 2:VAMC, PPH
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-2309
Mailing Address - Country:US
Mailing Address - Phone:612-467-3622
Mailing Address - Fax:612-467-5309
Practice Address - Street 1:1 VETERANS DR
Practice Address - Street 2:VAMC, PPH
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-2309
Practice Address - Country:US
Practice Address - Phone:612-467-3622
Practice Address - Fax:612-467-5309
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR092038-4163WP0809X
MNR 092038-4364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult