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NPI Code Detail

MEDICARE: MS. BONNIE KARINEN MSN, CRNP

MEDICARE: MS. BONNIE KARINEN MSN, CRNP
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
1363LF0000XFamily Nurse Practitioner4704173114MI
2363LF0000XFamily Nurse PractitionerR185408MD
3363LP0808XPsychiatric/Mental Health Nurse PractitionerNUR-APRN-LIC-100479MT

General Provider Information

NPI Number : 1558422329
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BONNIE KARINEN MSN, CRNP
Provider Business Mailing Address
First Line : 7780 FOUNTAIN HILLS LN
Second Line :
City : DAVISBURG
State : MI
Zip : 48350-2444
Country : US
Telephone Number : 404-936-0735
Fax Number :
Provider Business Practice Location Address
First Line : 39350 9 MILE RD
Second Line : SUITE 440
City : NORTHVILLE
State : MI
Zip : 48167-9164
Country : US
Telephone Number : 248-735-6081
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2006
Last Update Date : 03/18/2021

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