Individual
MARCUS A BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
600 CYPRESS ST, SULPHUR, LA 70663-5052
(337) 527-6371
(337) 528-2034
Mailing address
600 CYPRESS ST, SULPHUR, LA 70663-5052
(337) 527-6371
(337) 528-2034
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
079290APO4239
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1191078
—
LA
Enumeration date
03/22/2007
Last updated
06/21/2012
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