Provider Demographics
NPI:1033269782
Name:BISSONNETTE, IONE (CNM)
Entity Type:Individual
Prefix:
First Name:IONE
Middle Name:
Last Name:BISSONNETTE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 MILK ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-4806
Mailing Address - Country:US
Mailing Address - Phone:617-421-6540
Mailing Address - Fax:
Practice Address - Street 1:20 WALL ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4758
Practice Address - Country:US
Practice Address - Phone:781-221-2940
Practice Address - Fax:781-221-2940
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA7996207OtherCIGNA
MA0368610Medicaid
MAF237OtherHPHC
MACN0176OtherBCBS
MACN0176OtherBCBS