Provider Demographics
NPI:1881314839
Name:BONNEAU, HAILEY MARIE (NP)
Entity type:Individual
Prefix:MRS
First Name:HAILEY
Middle Name:MARIE
Last Name:BONNEAU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:HAILEY
Other - Middle Name:MARIE
Other - Last Name:NADEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:488 ELM ST
Mailing Address - Street 2:
Mailing Address - City:BARTON
Mailing Address - State:VT
Mailing Address - Zip Code:05822-8637
Mailing Address - Country:US
Mailing Address - Phone:802-525-3539
Mailing Address - Fax:
Practice Address - Street 1:488 ELM ST
Practice Address - Street 2:
Practice Address - City:BARTON
Practice Address - State:VT
Practice Address - Zip Code:05822-8637
Practice Address - Country:US
Practice Address - Phone:802-525-3539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0135672PROV363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily