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General NPI Number Information
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NPI Number | 1831441823
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Entity Type | Individual
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Provider Name | ERIN BOUDREAUX AZBELL APRN
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Gender | Female
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Dates
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Enumeration Date | 10/15/2012
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Last Update Date | 05/24/2022
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Provider Practice Location Address
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Address Line | 1517 NICHOLASVILLE RD STE 405
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City | LEXINGTON
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State | KY
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Zip | 40503-1429
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Country | US
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Telephone | 859-278-8469
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Fax |
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Provider Business Mailing Address
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Address Line | 4821 PLEASANT GROVE RD
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City | LEXINGTON
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State | KY
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Zip | 40515-1601
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Country | US
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Telephone | 52-873-0855
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 3007638
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License Number State | KY
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