Dr Nelly Esther Bonilla Bonilla, PSYD, LP is a
Psychologist based in Jordan, Minnesota. Dr Nelly Esther Bonilla Bonilla is licensed to practice in Puerto Rico (license number LP6839) and her current practice location is
863 Forest Edge Dr, Jordan, Minnesota. She can be reached at her office (for appointments etc.) via phone at
(612) 475-0505.
NPI number for Dr Nelly Esther Bonilla Bonilla is 1356830210 and her current mailing address is 863 Forest Edge Dr, Jordan, Minnesota. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1356830210.
Healthcare Provider's Profile
| Full Name | Dr Nelly Esther Bonilla Bonilla |
|---|
| Gender | Female |
|---|
| Speciality | Psychologist |
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| Location | 863 Forest Edge Dr, Jordan, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1356830210
- Provider Enumeration Date: 05/07/2018
- Last Update Date: 09/19/2024
Medical Identifiers
Medical identifiers for Dr Nelly Esther Bonilla Bonilla such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1356830210 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | LP6839 (Puerto Rico) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Nelly Esther Bonilla Bonilla is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Nelly Esther Bonilla Bonilla, PSYD, LP
863 Forest Edge Dr,
Jordan, MN 55352-4502
Ph: (612) 475-0505 | Dr Nelly Esther Bonilla Bonilla, PSYD, LP
863 Forest Edge Dr,
Jordan, MN 55352-4502
Ph: (612) 475-0505 |
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