Individual
MRS. BONNIE LYNN JAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(352) 214-8365
Mailing address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
888291
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP127564
TX
Other
Enumeration date
10/09/2007
Last updated
12/19/2022
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