Individual
BONNIE NADAENE GRUDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3700 N KICKAPOO AVE, SHAWNEE, OK 74804-1707
(405) 273-6383
(405) 214-1078
Mailing address
701 NE 36TH ST, OKLAHOMA CITY, OK 73105-7203
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201526
OK
Other
Enumeration date
05/12/2021
Last updated
04/01/2025
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