Individual
CAROLYN A. BOUTWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
810 ST. VINCENT'S DR., BIRMINGHAM, AL 35205
(205) 939-7143
Mailing address
PO BOX 1123, JACKSON, MI 49204-1123
(800) 242-1131
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-092497
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009992635
—
AL
01
—
515-26962
BC&BS OF ALABAMA
AL
Enumeration date
06/19/2006
Last updated
07/08/2007
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