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NPI Code Detail

MEDICARE: ASHLEY CHRISTINE BOUDREAU REGISTERED NURSE

MEDICARE: ASHLEY CHRISTINE BOUDREAU REGISTERED NURSE
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
1163W00000XRegistered Nurse4704289275MI

General Provider Information

NPI Number : 1760047088
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY CHRISTINE BOUDREAU REGISTERED NURSE
Provider Business Mailing Address
First Line : 3051 KIESEL RD
Second Line :
City : BAY CITY
State : MI
Zip : 48706-2449
Country : US
Telephone Number : 989-778-2854
Fax Number : 989-778-2887
Provider Business Practice Location Address
First Line : 3051 KIESEL RD
Second Line :
City : BAY CITY
State : MI
Zip : 48706-2449
Country : US
Telephone Number : 989-778-2854
Fax Number : 989-778-2887
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2019
Last Update Date : 05/02/2019

Similar Medicare Providers

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1578002317 — DAVID MOORE
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Practice Location Address:
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Directions to “ ASHLEY CHRISTINE BOUDREAU REGISTERED NURSE” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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