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Individual
BONNIE K OETMAN
Active
Individual
BONNIE K OETMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704098641
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N55170001
MEDICARE ADVANTAGE
MI
01
—
1059825
MCLAREN HEALTH ADVANTAGE
MI
05
—
4376184
—
MI
01
—
500020133
RAILROAD MEDICARE
MI
01
—
5008766030
BCBS
MI
01
—
9492259
AETNA
MI
Enumeration date
10/24/2006
Last updated
07/19/2010
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