Mrs Bonnie Lea Mack, CRNA is a
Nurse Anesthetist, Certified Registered based in Mountain Home A F B, Idaho. Mrs Bonnie Lea Mack is licensed to practice in Texas (license number 625810) and her current practice location is
90 Hope Dr, Mountain Home A F B, Idaho. She can be reached at her office (for appointments etc.) via phone at
(208) 828-7648.
NPI number for Mrs Bonnie Lea Mack is 1598747701 and her current mailing address is 1085 Julia St, Mountain Home, Idaho. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1598747701.
Provider's Profile
| Full Name | Mrs Bonnie Lea Mack |
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| Gender | Female |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 90 Hope Dr, Mountain Home A F B, Idaho |
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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: 1598747701
- Provider Enumeration Date: 11/15/2005
- Last Update Date: 06/14/2010
Medical Identifiers
Medical identifiers for Mrs Bonnie Lea Mack such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1598747701 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 625810 (Texas) | 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. Mrs Bonnie Lea Mack 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 |
|---|
Mrs Bonnie Lea Mack, CRNA
1085 Julia St,
Mountain Home, ID 83647-4687
Ph: (208) 599-0584 | Mrs Bonnie Lea Mack, CRNA
90 Hope Dr,
Mountain Home A F B, ID 83648-1057
Ph: (208) 828-7648 |
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