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NPI Code Detail

MEDICARE: DONNA MARIE BOULEY FNP-C

MEDICARE: DONNA MARIE BOULEY FNP-C
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
1363L00000XNurse Practitioner242548AZ

General Provider Information

NPI Number : 1205449105
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNA MARIE BOULEY FNP-C
Provider Business Mailing Address
First Line : 4254 W ORCHID LN
Second Line :
City : CHANDLER
State : AZ
Zip : 85226-7246
Country : US
Telephone Number : 888-731-8994
Fax Number :
Provider Business Practice Location Address
First Line : 4254 W ORCHID LN
Second Line :
City : CHANDLER
State : AZ
Zip : 85226-7246
Country : US
Telephone Number : 888-731-8994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2020
Last Update Date : 12/09/2025

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Directions to “ DONNA MARIE BOULEY FNP-C” Practice Location

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