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Individual

BONNIE THERESE MACKEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP,PHD

Contact information

Practice address
3177 MERIDIAN WAY S APT 3, PALM BEACH GARDENS, FL 33410-5055
(315) 246-8559
(561) 892-2999
Mailing address
12727 STATE ROUTE 90, LOCKE, NY 13092-4108
(315) 246-8559
(561) 892-2999

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1503092
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
305368
NY

Other

Enumeration date
07/23/2010
Last updated
10/15/2021
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