Provider Demographics
NPI:1881882074
Name:SJOL, BONNIE K (RN)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:K
Last Name:SJOL
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:PO BOX 2023
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58702-2023
Mailing Address - Country:US
Mailing Address - Phone:701-837-5433
Mailing Address - Fax:701-837-5434
Practice Address - Street 1:2401 ELK DR
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-5631
Practice Address - Country:US
Practice Address - Phone:701-837-5433
Practice Address - Fax:701-837-5434
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR20088163WP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0000XNursing Service ProvidersRegistered NursePain Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND354502Medicare Oscar/Certification