Individual
MICHELLE LEIGH BOUDOULAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
111 S GRANT AVE FL 3, COLUMBUS, OH 43215-4701
(614) 566-9871
(614) 566-9503
Mailing address
5350 FRANTZ RD, DUBLIN, OH 43016-4259
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN356051
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
11447-NA
OH
Other
Enumeration date
03/25/2010
Last updated
11/20/2013
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