Individual
MS. ELIZABETH N BOULETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-8951
Mailing address
11344 PENANOVA ST, SAN DIEGO, CA 92129-1028
(858) 672-9634
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
051734
CA
Other
Enumeration date
10/24/2006
Last updated
08/13/2007
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