Individual
MR. PHILIPPE BONNEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
455 SAINT MICHAELS DR, SANTA FE, NM 87505-7601
(505) 820-5554
(505) 820-5440
Mailing address
455 SAINT MICHAELS DR, CARLA GOMEZ, CREDENTIALING COORDINTOR, SANTA FE, NM 87505-7601
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA00322
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
94433
—
NM
Enumeration date
08/08/2006
Last updated
12/22/2014
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