Healthcare Provider Details

I. General information

NPI: 1508084310
Provider Name (Legal Business Name): BONNIE JEAN PLINE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BONNIE JEAN ARENDS DO

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1042 S. RAVENNA RD.
RAVENNA MI
49451
US

IV. Provider business mailing address

1042 S. RAVENNA RD.
RAVENNA MI
49451
US

V. Phone/Fax

Practice location:
  • Phone: 231-853-2519
  • Fax: 231-853-2838
Mailing address:
  • Phone: 231-853-2519
  • Fax: 231-853-2838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101017025
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: