Individual
BREANN A. BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1401 FOUCHER ST, NEW ORLEANS, LA 70115-3515
(504) 897-7011
(504) 897-8394
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
328277
LA
Other
Enumeration date
08/02/2021
Last updated
08/02/2021
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