Provider Demographics
NPI:1013930833
Name:ENGEL, BONNIE L (APRN, CS)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:L
Last Name:ENGEL
Suffix:
Gender:F
Credentials:APRN, CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 N 19TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4720
Mailing Address - Country:US
Mailing Address - Phone:701-224-8783
Mailing Address - Fax:
Practice Address - Street 1:418 N 2ND ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-3826
Practice Address - Country:US
Practice Address - Phone:701-224-8783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR20929364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent