Provider Demographics
NPI:1942630835
Name:BROWNELL, BONNIE (NP)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:BROWNELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 FAIRHURST ST
Mailing Address - Street 2:FAMILY CARE CLINIC
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-4523
Mailing Address - Country:US
Mailing Address - Phone:970-521-3251
Mailing Address - Fax:970-521-2366
Practice Address - Street 1:615 FAIRHURST ST
Practice Address - Street 2:FAMILY CARE CLINIC
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-4523
Practice Address - Country:US
Practice Address - Phone:970-521-3251
Practice Address - Fax:970-521-2366
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0990887-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily