Individual
MRS. TERESA FAYE BOUDRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8500
(270) 798-8666
Mailing address
9215 ELKHORN RD, SPRINGVILLE, TN 38256-4962
(731) 336-2598
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
130082
TN
Other
Enumeration date
07/21/2009
Last updated
07/21/2009
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