Healthcare Provider Details

I. General information

NPI: 1881882074
Provider Name (Legal Business Name): BONNIE K SJOL R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2007
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 ELK DR
MINOT ND
58701-5631
US

IV. Provider business mailing address

PO BOX 2023
MINOT ND
58702-2023
US

V. Phone/Fax

Practice location:
  • Phone: 701-837-5433
  • Fax: 701-837-5434
Mailing address:
  • Phone: 701-837-5433
  • Fax: 701-837-5434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License NumberR20088
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: