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Individual
MICHELLE THERESA BOUDREAUX
Active
Individual
MICHELLE THERESA BOUDREAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
21936-875
WI
363LN0005X
Critical Care Neonatal Nurse Practitioner
RN047884
LA
363LP0200X
Pediatric Nurse Practitioner
RN047884
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1722898
—
LA
Enumeration date
07/21/2006
Last updated
03/07/2022
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