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Contact Information

AMY BOUDONCK
1406 N 39TH ST
EAST SAINT LOUIS, IL62204-2431
 Phone: 314-482-3706
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for AMY BOUDONCK · (Female)

NPI Number 1295385888
Status Active
Credentials
Entity Individual
Enumeration date 09/16/2019
Last updated 09/16/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • MO License # 2008023288
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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