Individual
BONITA PERRINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2525 CHICAGO AVE, MINNEAPOLIS, MN 55404-4518
(612) 813-6000
Mailing address
2525 CHICAGO AVE, MINNEAPOLIS, MN 55404-4518
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
61185124
WA
163WP0200X
Pediatric Registered Nurse
2458932
MN
363LP0200X
Pediatric Nurse Practitioner
Primary
61206206
WA
Other
Enumeration date
05/29/2020
Last updated
08/08/2025
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