Individual
MRS. TRACY KATHERINE BONO-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
550 POPE AVE, MUNSON ARMY HEALTH CENTER ATTN MCXN-COD MS. COTTON, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6562
(913) 684-6208
Mailing address
550 POPE AVE, MUNSON ARMY HEALTH CENTER ATTN MCXN-COD MS. COTTON, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6562
(913) 684-6208
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
2006021076
MO
164W00000X
Licensed Practical Nurse
Primary
24-35850-062
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006021076
LPN IV CERTIFIED
MO
01
—
24-35850-062
LPN IV CERTIFIED
KS
Enumeration date
06/25/2007
Last updated
07/08/2007
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