Individual
AMANDA BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
320 AKERS AVE, KINGSPORT, TN 37665-1934
(972) 890-7839
Mailing address
320 AKERS AVE, KINGSPORT, TN 37665-1934
(972) 890-7839
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201347
TN
Other
Enumeration date
11/16/2014
Last updated
11/16/2014
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