Provider Demographics
NPI:1598957722
Name:MADIGAN, BONNIE JEANNE (LPN)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:JEANNE
Last Name:MADIGAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01835-7248
Mailing Address - Country:US
Mailing Address - Phone:978-457-0934
Mailing Address - Fax:
Practice Address - Street 1:54 LAUREL AVE
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01835-7248
Practice Address - Country:US
Practice Address - Phone:978-457-0934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-12
Last Update Date:2007-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA61145164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse