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General NPI Number Information
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NPI Number | 1124571567
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Entity Type | Individual
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Provider Name | BONNIE JEANNE BOUDAKIAN R.N., B.S.N.
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Gender | Female
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Dates
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Enumeration Date | 08/02/2016
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Last Update Date | 08/02/2016
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Provider Practice Location Address
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Address Line | 3033 S PARKER RD SUITE 300
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City | AURORA
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State | CO
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Zip | 80014-2910
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Country | US
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Telephone | 720-577-1804
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Fax | 720-577-1803
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Provider Business Mailing Address
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Address Line | 3033 S PARKER RD SUITE 300
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City | AURORA
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State | CO
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Zip | 80014-2910
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Country | US
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Telephone | 720-577-1804
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Fax | 720-577-1803
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN.1637831
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License Number State | CO
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