| NPI | 1508118159 |
|---|---|
| Former Name | ASHLEY BOUDREAU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71004083A) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71004083A) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 28148140A) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 209012386) | |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2020-12-22 |