Provider Demographics
NPI:1235508227
Name:BONENFANT, ANDREA F (FNP-C)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:F
Last Name:BONENFANT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:F
Other - Last Name:LEMOINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:87 MCGREGOR ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3765
Mailing Address - Country:US
Mailing Address - Phone:603-695-2940
Mailing Address - Fax:603-695-2960
Practice Address - Street 1:87 MCGREGOR ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3765
Practice Address - Country:US
Practice Address - Phone:603-695-2940
Practice Address - Fax:603-695-2960
Is Sole Proprietor?:No
Enumeration Date:2015-09-19
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2291498363LF0000X
NH069390-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily