Individual
BONITA FAYE CONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
40520 CO HWY 34, WHITE EARTH HEALTH CENTER, OGEMA, MN 56569
(218) 983-4300
(218) 983-6217
Mailing address
2205 290TH ST, WAUBUN, MN 56589
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R1180880
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0121298
MEDICA
—
01
—
376G7C0
BCBS
—
01
—
585241045697
PREFERRED ONE
—
Enumeration date
06/21/2006
Last updated
07/08/2007
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