person
Bonnie Clark, PAC
Medical Physician Assistant in Albuquerque, New Mexico
NPI 1508899170

Bonnie Clark is a Medical Physician Assistant based in Albuquerque, NM and is specialized in Medical. Bonnie Clark practices in Albuquerque, NM and has the professional credentials of PAC. The NPI Number for Bonnie Clark is 1508899170 and holds a License No. 79-PA004 (New Mexico).

The current practice location address for Bonnie Clark is 5400 Gibson Blvd Se, Albuquerque, NM and can be reached out via phone at 505-262-7026 and via fax at 505-727-9276.

Location: 5400 Gibson Blvd Se, Albuquerque, NM, 87108-4729
person
Provider Profile Details
NPI Number
1508899170
Provider Name
Bonnie Clark
Credential
PAC
Provider Entity Type
Individual
Gender
Female
Address
5400 Gibson Blvd Se, Albuquerque, NM, 87108-4729
Phone Number
505-262-7026
Fax Number
505-727-9276
Provider Enumeration Date
07/08/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
59428 05 NM
institution
Provider Business Practice Location Address Details
Address
5400 Gibson Blvd Se
City
State
Zip
87108-4729
Phone Number
505-262-7026
Fax Number
505-727-9276
person
Provider Business Mailing Address Details
Address
5400 Gibson Blvd Se
City
State
Zip
87108-4729
Phone Number
505-262-7026
Fax Number
505-727-9276
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
79-PA004 (New Mexico)
Definition
Definition to come...
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