| Doctor Name: | BONNIE AYCOCK |
| NPI Number: | 1548683873 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RN114964 |
| Business Practice Address: | 3706 Main St Belle Chasse, LA - 700373002 |
| Business Phone Number: | 5043943510 |
| Business Fax Number: | 5043930437 |
| Mailing Address: | Po Box 61979, NEW ORLEANS |
| State: | LA |
| Postal Code: | 701611979 |
| Phone Number: | 2253427867 |
| Fax Number: | 2253420886 |
| NPI Enumeration Date: | 01/22/2014 |
| NPI Last Update Date: | 01/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | RN114964 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |