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Individual

MS. SHAUNEEN MARIE BOUTHILETTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
504 COLLEGE VIEW DR, ELIZABETHTOWN, KY 42701-3072
(270) 723-7475
Mailing address
504 COLLEGE VIEW DR, ELIZABETHTOWN, KY 42701-3072
(270) 723-7475

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1077845
KY
163W00000X
Registered Nurse
Primary
28199596A
IN

Other

Enumeration date
01/24/2012
Last updated
01/24/2012
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