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NPI Code Detail

MEDICARE: BONNIE A WILENSKY C.N.S.

MEDICARE: BONNIE A WILENSKY C.N.S.
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
1364S00000XClinical Nurse SpecialistAPN.0004455-CNSCO

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 : 1467435347
Entity Type Code : Individual
Provider Name (Legal Business Name) : BONNIE A WILENSKY C.N.S.
Provider Business Mailing Address
First Line : 5450 WESTERN AVE
Second Line :
City : BOULDER
State : CO
Zip : 80301-2709
Country : US
Telephone Number : 303-415-4355
Fax Number : 303-666-1982
Provider Business Practice Location Address
First Line : 1000 W SOUTH BOULDER RD STE 110
Second Line :
City : LAFAYETTE
State : CO
Zip : 80026-2753
Country : US
Telephone Number : 303-415-4355
Fax Number : 303-666-1982
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2005
Last Update Date : 07/21/2022

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