| NPI | 1316977275 |
|---|---|
| Former Name | CAROLE R BOUDREAU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004402) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: KY 1068394) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2016-12-01 |