Individual
MICHELLE C BOUDRIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1902 WINDSOR PL STE 102, FORT WORTH, TX 76110-1866
(682) 207-1700
(682) 250-5246
Mailing address
1902 WINDSOR PL STE 102, FORT WORTH, TX 76110-1866
(682) 207-1700
(682) 250-5246
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP115310
TX
363LA2100X
Acute Care Nurse Practitioner
636309
TX
Other
Enumeration date
11/01/2006
Last updated
03/31/2021
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