MEDICARE: CLAUDY BONNE ANNEE FNP, MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	NY767064	NY
2	163W00000X	Registered Nurse	767064	NY
3	207Q00000X	Family Medicine Physician	HSE6403	FL
4	363LF0000X	Family Nurse Practitioner	95034645	CA
5	363LF0000X	Family Nurse Practitioner	APRN11014614	FL
6	363LP2300X	Primary Care Nurse Practitioner	320419	AZ
7	363LP2300X	Primary Care Nurse Practitioner	F348961-01	NY
8	363LP2300X	Primary Care Nurse Practitioner	320418	AZ
9	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	406944	NY

General Provider Information

NPI Number	:	1982268926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDY BONNE ANNEE FNP, MD

Provider Business Mailing Address
First Line	:	1142 SW SUDDER AVE
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34953
Country	:	US
Telephone Number	:	413-735-3149
Fax Number	:

Provider Business Practice Location Address
First Line	:	1541 TOMLINSON AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1526
Country	:	US
Telephone Number	:	718-892-6600
Fax Number	:	718-892-6600

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2019
Last Update Date	:	08/13/2025

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