Susan Bonnie Pulkowski, APN

Individual provider Active NPI Family Nurse Practitioner · Menominee, MI

NPI 1194901686 · NPPES record last updated Jun 14, 2023

Key facts

NPI
1194901686
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
7599 (WI)
Practice address
305 Henes Park Dr
Menominee, MI 49858-1417
Phone
(815) 543-3352
NPI assigned
Jan 14, 2008
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)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7599 WI Yes

Addresses

Primary practice location

305 Henes Park Dr
Menominee, MI 49858-1417

Mailing address

305 Henes Park Dr
Menominee, MI 49858-1417
Phone (815) 543-3352

Other names

  • Bonnie Susan McKittrick Former name

Other providers in Menominee, MI

All providers in Menominee, MI · Family Nurse Practitioner in Michigan

Sources for this page

Verify at the official NPI Registry.