Individual
BONNIE WHITE MARSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1 VETERANS DR # 112, MINNEAPOLIS, MN 55417-2309
(612) 725-2148
(612) 725-1920
Mailing address
1 VETERANS DR # 112, MINNEAPOLIS, MN 55417-2309
(612) 725-2148
(612) 725-1920
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
9078
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9078
PHYSICIAN ASST REGISTRATI
MN
Enumeration date
09/14/2006
Last updated
07/08/2007
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