Individual
MRS. ANNMARIE GREEN BOLDUC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1617 TAMIAMI TRL, PORT CHARLOTTE, FL 33948-1040
(941) 613-2400
(941) 613-2401
Mailing address
3322 PURPLE MARTIN DR UNIT 142, PUNTA GORDA, FL 33950-6746
(860) 655-3395
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
005213
CT
363L00000X
Nurse Practitioner
Primary
11015846
FL
363LA2200X
Adult Health Nurse Practitioner
005213
CT
Other
Enumeration date
11/15/2012
Last updated
01/05/2023
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