Individual
HOLLIE BONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
835 PRIDE DR, HAMMOND, LA 70401-9527
(985) 543-4333
(985) 543-4817
Mailing address
28493 ROSEDUST LN, PONCHATOULA, LA 70454-8448
(985) 237-9697
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20180469
LA
Other
Enumeration date
04/16/2021
Last updated
04/16/2021
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