Provider Demographics
NPI:1568520211
Name:RICHTER, BONNIE M (RN)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:M
Last Name:RICHTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BONITA
Other - Middle Name:M
Other - Last Name:KRUSSOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7030 42ND WAY N
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33404-5830
Mailing Address - Country:US
Mailing Address - Phone:561-840-9829
Mailing Address - Fax:
Practice Address - Street 1:7305 N MILITARY TRL
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-7417
Practice Address - Country:US
Practice Address - Phone:561-422-8370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR067821-2163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care