Organization
MARGARET HEFFERNAN BONIFACIO
Active
Other names
Bonifacio Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
MARGARET H BONIFACIO (OWNER/PROVIDER)
(865) 387-2904
Entity
Organization
Contact information
Practice address
307 N 5TH ST, MARYVILLE, TN 37804-2921
(865) 246-2104
(865) 246-2106
Mailing address
PO BOX 5777, MARYVILLE, TN 37802-5777
(865) 246-2104
(865) 246-2106
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APM0000017637
TN
Other
Enumeration date
07/22/2013
Last updated
04/08/2026
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