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Individual

MS. BONNIE M MCCLURE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1200 E MICHIGAN AVE, LANSING, MI 48912-1800
(517) 364-5210
(517) 364-5216
Mailing address
PO BOX 13008, LANSING, MI 48901-3008
(517) 364-6253
(517) 364-6208

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704081390
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4262808
MI
01
5008764590
BCBS INDIVIDUAL PIN
MI
Enumeration date
10/20/2006
Last updated
07/08/2007
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