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General NPI Number Information
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NPI Number | 1912048950
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Entity Type | Individual
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Provider Name | BONNIE L HERT
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Gender | Female
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Dates
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Enumeration Date | 02/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | N6185 SCHOOL CREEK TRL
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City | LUXEMBURG
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State | WI
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Zip | 54217-1035
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Country | US
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Telephone | 920-845-2128
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Fax |
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Provider Business Mailing Address
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Address Line | N4420 COUNTY ROAD C
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City | PULASKI
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State | WI
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Zip | 54162-7619
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Country | US
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Telephone | 715-758-8712
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State | WI
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