Individual
MRS. ERIN BOUDREAUX AZBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1517 NICHOLASVILLE RD STE 405, LEXINGTON, KY 40503-1429
(859) 278-8469
Mailing address
4821 PLEASANT GROVE RD, LEXINGTON, KY 40515-1601
(052) 873-0855
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3007638
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000887724
ANTHEM-NMA
KY
01
—
164897
SIHO
KY
01
—
50074386
PASSPORT-NMA
KY
05
—
7100223490
—
KY
Enumeration date
10/15/2012
Last updated
05/24/2022
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