Provider Demographics
NPI:1326338773
Name:BONDARENKO, ASHLIE ANN (RN, FNP-C)
Entity Type:Individual
Prefix:
First Name:ASHLIE
Middle Name:ANN
Last Name:BONDARENKO
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:ASHLIE
Other - Middle Name:ANN
Other - Last Name:GRUBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7235 OHMS LN
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2148
Mailing Address - Country:US
Mailing Address - Phone:952-841-2345
Mailing Address - Fax:952-841-2346
Practice Address - Street 1:14551 COUNTY ROAD 11 STE 100
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4799
Practice Address - Country:US
Practice Address - Phone:952-841-2345
Practice Address - Fax:952-841-2346
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 197213-7163W00000X
MN5291363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner