MRS. Bonnie Lea Mack, CRNA
NPI #1598747701 in Mountain Home a F B, Idaho
Provider Information
- NPI Number
- 1598747701
- Entity Type
- Individual
- Name
- MRS. Bonnie Lea Mack, CRNA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Anesthetist, Certified Registered
- Credential
- CRNA
- Enumeration Date
- Nov 15, 2005
- Last Updated
- Jun 14, 2010
Practice Location
- Address
- 90 HOPE DR
- State
- Idaho
- ZIP Code
- 83648-1057
- Phone
- (208) 828-7648
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Anesthetist, Certified Registered |
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