Provider Demographics
NPI:1598720005
Name:CHUK, BONNIE (MSN, CNP, APRN)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:CHUK
Suffix:
Gender:F
Credentials:MSN, CNP, APRN
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:
Other - Last Name:CHUK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, CNP, CSN
Mailing Address - Street 1:8 PILGRIM HILL RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360
Mailing Address - Country:US
Mailing Address - Phone:508-747-1465
Mailing Address - Fax:
Practice Address - Street 1:8 PILGRIM RD
Practice Address - Street 2:CVS MINUTE CLINIC
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360
Practice Address - Country:US
Practice Address - Phone:508-747-1465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA194654363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
M15639OtherBCBS
M15639Medicare ID - Type Unspecified
NP4177Medicare ID - Type Unspecified
M15639OtherBCBS