Mack, Bonnie Lea

Mack, Bonnie Lea is an individual health care provider with primary practice located at 90 Hope Dr , Mountain Home A F B ID 83648-1057. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Mack, Bonnie Lea can be contacted via phone (208) 828-7648.

Contact Information

Primary practice address
90 Hope Dr Mountain Home A F B ID 83648-1057
Phone: (208) 828-7648
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 625810 Texas

Profile Details

NPI number 1598747701
LBN Legal business name Mack, Bonnie Lea
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2005
Last updated Jun 14th, 2010 - about 14 years ago

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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