Individual
SUZANNE C BONVILLAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
600 VALHI BLVD, HOUMA, LA 70360-5976
(985) 872-3677
Mailing address
600 VALHI BLVD, HOUMA, LA 70360-5976
(985) 872-3677
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
131229
LA
363L00000X
Nurse Practitioner
231514
LA
363LF0000X
Family Nurse Practitioner
Primary
F07230255
LA
Other
Enumeration date
08/09/2023
Last updated
08/29/2023
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