Provider Demographics
NPI:1972924579
Name:BONEAU, FRANTZ (BA/LPN)
Entity type:Individual
Prefix:MR
First Name:FRANTZ
Middle Name:
Last Name:BONEAU
Suffix:
Gender:M
Credentials:BA/LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 BLUE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-1106
Mailing Address - Country:US
Mailing Address - Phone:857-203-1537
Mailing Address - Fax:
Practice Address - Street 1:2067 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-1340
Practice Address - Country:US
Practice Address - Phone:617-575-5513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-27
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN88848164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse