| NPI | 1689121881 |
|---|---|
| Former Name | ANDREA BOULDIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OH 422140) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0029137) |
| Enumeration Date | 2016-09-06 |
| Last Update Date | 2022-03-16 |