Brenda S Bonnichsen, RN

Individual provider Active NPI Registered Nurse · Fort Meade, SD

NPI 1114718608 · NPPES record last updated May 14, 2025

Key facts

NPI
1114718608
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
R045041 (SD)
Practice address
113 Comanche Rd
Fort Meade, SD 57741-1002
Phone
(605) 347-2511
NPI assigned
May 14, 2025
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R045041SDMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R045041 SD Yes

Addresses

Primary practice location

113 Comanche Rd
Fort Meade, SD 57741-1002

Mailing address

113 Comanche Rd
Fort Meade, SD 57741-1002
Phone (605) 347-2511

Other providers in Fort Meade, SD

All providers in Fort Meade, SD · Registered Nurse in South Dakota

Sources for this page

Verify at the official NPI Registry.