Individual
JENNIFER S BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1410 KINGS HWY, SHREVEPORT, LA 71103-4227
(318) 585-0420
Mailing address
1410 KINGS HWY, SHREVEPORT, LA 71103-4227
(318) 585-0420
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15716
LA
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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