Individual
BONNIE JEAN MACKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5445 LA BRANCH ST, HOUSTON, TX 77004-6835
(713) 525-7997
Mailing address
1511 OLD ALVIN RD, PEARLAND, TX 77581
(281) 997-2623
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
443088
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
443088
NURSING LICENSE
TX
Enumeration date
05/08/2006
Last updated
07/08/2007
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