Individual
CATHERINE WAITZ BONNEVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4370 HIGHWAY 1, RACELAND, LA 70394-3866
(985) 209-2303
Mailing address
4370 HIGHWAY 1, RACELAND, LA 70394-3866
(985) 209-2303
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
203921
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22621171
NCSBN ID
LA
Enumeration date
02/22/2019
Last updated
02/22/2019
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