Active NPI
Bonnie Evans
- Registered Nurse
- Grand Haven, MI
National Provider Identifier
1346774577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 4704094585
- Practice address
- 508 Monroe Ave
Grand Haven, MI 49417-1063 - Phone
- (616) 834-3526
- NPI assigned
- Apr 14, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704094585 | MI | Primary |
Addresses
Primary practice location
508 Monroe Ave
Grand Haven, MI 49417-1063
Mailing address
12265 James St
Holland, MI 49424-8613
Phone (616) 392-1873
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704094585 | MI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492128000000",
"number": "1346774577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12265 JAMES ST",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494248613",
"telephone_number": "616-392-1873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 MONROE AVE",
"city": "GRAND HAVEN",
"state": "MI",
"postal_code": "494171063",
"telephone_number": "616-834-3526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "BONNIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-14",
"last_updated": "2017-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704094585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Haven, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.