Provider Demographics
NPI:1891179982
Name:BONADONA, DARLENE (FNP)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:BONADONA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1937 S BURNSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-4632
Mailing Address - Country:US
Mailing Address - Phone:225-647-8511
Mailing Address - Fax:225-644-5213
Practice Address - Street 1:2647 S SAINT ELIZABETH BLVD STE 221
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-5020
Practice Address - Country:US
Practice Address - Phone:225-765-5500
Practice Address - Fax:225-644-2023
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08452363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily