Individual
BONNIE L DEJARDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-BC
Contact information
Practice address
704 S WEBSTER AVE, GREEN BAY, WI 54301-3528
(920) 433-6050
(920) 433-6049
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6710-33
WI
Other
Enumeration date
12/03/2015
Last updated
06/28/2019
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