Individual provider · Type 1 NPI

Mackenzie Bonnewitz, PA-C

Physician Assistant · Broken Arrow, OK

NPI number 1487438560 Active

Practice location

2530 N Elm Pl
Broken Arrow, OK 74012-1285

Call (918) 994-1402 Map

Fax (918) 512-4806

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XNone listed

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1487438560

Mackenzie Bonnewitz, PA-C's National Provider Identifier is 1487438560, issued on Aug 21, 2023. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Broken Arrow, OK. The record was last updated on Jan 7, 2026.