Individual
MR. ANDREW GERARD BOUDREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
580 W COLLEGE AVE, MARQUETTE, MI 49855-2705
(906) 225-4531
(906) 225-4807
Mailing address
PO BOX 220, MARQUETTE, MI 49855-0220
(906) 225-3630
(906) 225-4537
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704174895
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4958447
—
MI
Enumeration date
07/19/2006
Last updated
02/25/2008
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