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JOHN BOUDOURIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
1560 S HIGH ST, COLUMBUS, OH 43207-1803
(614) 274-1455
(614) 274-1433
Mailing address
1160 W BROAD ST, COLUMBUS, OH 43222-1352

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.461770
OH
363L00000X
Nurse Practitioner
Primary
APRN.CNP.0027959
OH

Other

Enumeration date
12/03/2019
Last updated
11/01/2023
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