Individual
MRS. BONNETTA MARLENE MATTISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
55005 897 RD LOT 203, CROFTON, NE 68730-3259
(402) 388-4333
Mailing address
55005 897 RD LOT 203, CROFTON, NE 68730-3259
(402) 388-4333
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
18602
NE
Other
Enumeration date
08/26/2009
Last updated
08/26/2009
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