Individual
MRS. TAYLOR K BOUDREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
242 GREEN ST, GARDNER, MA 01440-1336
(978) 632-3420
Mailing address
250 GREEN ST STE 104, GARDNER, MA 01440-1377
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2279791
MA
363LA2100X
Acute Care Nurse Practitioner
RN2279791
MA
363LF0000X
Family Nurse Practitioner
RN2279791
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110118892A
—
MA
Enumeration date
07/22/2016
Last updated
04/16/2025
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