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Individual

MRS. BONNIE ANGUS DOUBLEDAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1415 TULANE AVE, HC 71, NEW ORLEANS, LA 70112-2600
(504) 988-5800
Mailing address
61 CHATEAU DULAC, KENNER, LA 70065-2060
(504) 469-4308

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN025068
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP01600
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1959162
LA
01
P00391825
RAILROAD MEDICARE
GA
Enumeration date
04/17/2007
Last updated
11/17/2007
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