Individual
CAROL ANNE BOULAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
6198 52ND ST S, ST PETERSBURG, FL 33715-2405
(727) 409-9211
Mailing address
6198 52ND ST S, ST PETERSBURG, FL 33715-2405
(727) 409-9211
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
1756222
FL
363LG0600X
Gerontology Nurse Practitioner
1756222
FL
Other
Enumeration date
04/16/2017
Last updated
04/16/2017
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