Individual
MRS. BONNIE SUSANNAH MACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
18018 N 45TH PL, PHOENIX, AZ 85032-1521
(317) 490-1124
Mailing address
18018 N 45TH PL, PHOENIX, AZ 85032-1521
(317) 490-1124
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
TRN190693
AZ
Other
Enumeration date
03/05/2015
Last updated
03/05/2015
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