Provider Demographics
NPI:1437453792
Name:DUHON, BONNY M (NP)
Entity Type:Individual
Prefix:
First Name:BONNY
Middle Name:M
Last Name:DUHON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 N AVENUE G
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-4438
Mailing Address - Country:US
Mailing Address - Phone:337-785-8003
Mailing Address - Fax:337-785-8045
Practice Address - Street 1:1526 N AVENUE I
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-2434
Practice Address - Country:US
Practice Address - Phone:337-788-3330
Practice Address - Fax:337-788-3338
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA113493-6331363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health