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Mrs. BONNIE LEA MACK -- CRNA

Individual Provider (NPI-1) Active

Nurse Anesthetist, Certified Registered

Provider Information

NPI Number
1598747701
Provider Type
Individual Provider (NPI-1)
Credentials
CRNA
Status
Active

Contact & Location

Address
90 HOPE DR, MOUNTAIN HOME A F B, ID, 836481057
Phone
(208) 828-7648

Specialties & Taxonomies

Nurse Anesthetist, Certified Registered Primary License: TX #625810

All Addresses

MAILING

1085 JULIA ST

MOUNTAIN HOME, ID, 836474687

(208) 599-0584

LOCATION

90 HOPE DR

MOUNTAIN HOME A F B, ID, 836481057

(208) 828-7648