Individual
BONITA J. WENDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP/BC
Contact information
Practice address
2061 CHEYENNE CT, GRAFTON, WI 53024-9368
(262) 376-1934
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(262) 376-1934
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3244
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36050600
—
WI
Enumeration date
11/02/2007
Last updated
11/15/2011
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