Lookup NPI Numbers from the NPI Registry
NPI Profile for JENNIFER K BOUDREAUX in MEDFORD, OR.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pediatrics |
363LP0200X | 50 | Nurse Practitioner | |
Psychiatric/Mental Health |
363LP0808X | 50 | Nurse Practitioner |
| NPI # | 1790038495 |
|
| Status | Active | |
| Credentials | MSN, CPNP-PC, PMHS | |
| Entity | Individual | |
| Enumeration date | 10/18/2012 | |
| Last updated | 11/28/2023 - About 3 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JENNIFER K BOUDREAUX
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JENNIFER K BOUDREAUX, MSN, CPNP-PC, PMHS