MEDICARE: MAEGAN BONNER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	11613521-3102	UT

General Provider Information

NPI Number	:	1427981182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAEGAN BONNER

Provider Business Mailing Address
First Line	:	1250 E BURKHILL DR
Second Line	:
City	:	EAGLE MOUNTAIN
State	:	UT
Zip	:	84005-5266
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 E BURKHILL DR
Second Line	:
City	:	EAGLE MOUNTAIN
State	:	UT
Zip	:	84005-5266
Country	:	US
Telephone Number	:	435-777-4057
Fax Number	:	435-777-4057

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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Directions to “ MAEGAN BONNER ” Practice Location

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