National Provider Identifier Database

JEANNE M BOUDRIEAU, ARNP – NPI #1669445359
Family


Contact Information

JEANNE M BOUDRIEAU, ARNP
1450 NORTHWEST LN SE
PROVIDENCE ST. PETER CLINIC AT PANORAMA
LACEY, WA98503-6908
Phone: 360-491-4460
Fax: 360-491-3090
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for JEANNE M BOUDRIEAU

NPI Number 1669445359
Credentials ARNP (Advanced Registered Nurse Practitioner)
Entity Individual
Enumeration date 02/11/2006
Last updated 02/27/2014 - About 12 years ago
Sole proprietor1 No
Identifiers
  • WA License #: AP30004530
  • WA Medicaid: 9621798
Hospital affiliation n/a

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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