Individual
JAYME L BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1200 AVENUE G, MARRERO, LA 70072-3765
(504) 349-6713
(504) 349-3733
Mailing address
1200 AVENUE G, MARRERO, LA 70072-3765
(504) 834-0626
(504) 833-9480
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP06893
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2305026
—
LA
Enumeration date
07/17/2012
Last updated
12/14/2012
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