Orellana Bonilla, Dennis M

Orellana Bonilla, Dennis M is an individual health care provider with primary practice located at 12500 Aurora Dr , Pleasant Prairie WI 53158-1227. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Orellana Bonilla, Dennis M can be contacted via phone (262) 857-5000.

Contact Information

Primary practice address
12500 Aurora Dr Pleasant Prairie WI 53158-1227
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 10203 Wisconsin

Profile Details

NPI number 1992177976
LBN Legal business name Orellana Bonilla, Dennis M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 29th, 2015
Last updated Sep 27th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992177976 NPPES
Wisconsin MEDICAID 100104753

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