Provider Demographics
NPI:1851583587
Name:MILLER, BONNIE SUZANNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:SUZANNE
Last Name:MILLER
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 1:106 NORTH 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-1034
Mailing Address - Country:US
Mailing Address - Phone:218-998-3778
Mailing Address - Fax:218-998-3187
Practice Address - Street 1:23123 OAKVIEW HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-8169
Practice Address - Country:US
Practice Address - Phone:218-998-3778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1238978163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse