Individual
MRS. BONITA L GILBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
850 WEST BARAGA AVENUE SUITE 30, MARQUETTE, MI 49855
(906) 225-3914
(906) 225-4583
Mailing address
850 WEST BARAGA AVENUE SUITE 30, MARQUETTE, MI 49855
(906) 225-3914
(906) 225-4583
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704201809
MI
363L00000X
Nurse Practitioner
Primary
4704201809
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0870871
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
05
—
33393472
—
MI
Enumeration date
08/25/2006
Last updated
05/05/2021
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