Individual
BONNIE B WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1615 CANAL ST, SUITE B, NEW ORLEANS, LA 70112-2819
(504) 308-3292
(504) 309-8354
Mailing address
4645 NOTTINGHAM DR, NEW ORLEANS, LA 70127-3928
(504) 308-3291
(504) 309-8354
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20120497
LA
Other
Enumeration date
10/04/2016
Last updated
10/04/2016
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