Individual
MRS. AILLISE B. BONHOMME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
322 W ELIZABETH AVE, APT. 1F, LINDEN, NJ 07036-4250
(862) 452-5489
Mailing address
322 W ELIZABETH AVE, APT. 1F, LINDEN, NJ 07036-4250
(862) 452-5489
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
26NR20187200
NJ
164W00000X
Licensed Practical Nurse
26NP06743000
NJ
Other
Enumeration date
08/14/2013
Last updated
01/22/2020
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