Individual
BONNIE MCMANAMON HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4228 HOUMA BLVD STE 130, METAIRIE, LA 70006-3003
(504) 454-2222
(504) 454-2388
Mailing address
4200 HOUMA BLVD, MEDICAL STAFF SERVICES, METAIRIE, LA 70006-2429
(504) 503-6781
(504) 503-5667
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200729
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08404301
—
MS
05
—
2380613
—
LA
Enumeration date
09/11/2014
Last updated
12/02/2022
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