Individual
STEPHANIE BOULTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2004 HAYES ST STE 200, NASHVILLE, TN 37203-2689
(615) 324-1600
Mailing address
2228B CRUZEN ST, NASHVILLE, TN 37211-2105
(240) 447-9984
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA3636
TN
363AS0400X
Surgical Physician Assistant
Primary
PA3636
TN
Other
Enumeration date
07/28/2015
Last updated
06/29/2025
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