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NPI Code Detail

MEDICARE: BONNIE L ST. JOHN N.P.

MEDICARE: BONNIE L ST. JOHN N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice Midwife63477CO
2363L00000XNurse Practitioner63477CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407815475
Entity Type Code : Individual
Provider Name (Legal Business Name) : BONNIE L ST. JOHN N.P.
Provider Business Mailing Address
First Line : 615 FAIRHURST ST
Second Line :
City : STERLING
State : CO
Zip : 80751-4523
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 615 FAIRHURST ST
Second Line :
City : STERLING
State : CO
Zip : 80751-4564
Country : US
Telephone Number : 970-526-8100
Fax Number : 970-521-3183
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2006
Last Update Date : 11/01/2019

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Directions to “ BONNIE L ST. JOHN N.P.” Practice Location

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