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Individual

GENEVIEVE C BOULAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4420
Mailing address
1218 N MAIN ST, PUEBLO, CO 81003-2828
(719) 533-7877
(719) 543-7882

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
184463
CO
367500000X
Certified Registered Nurse Anesthetist
480224
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
184463
COLORADO LICENSE
CO
Enumeration date
12/03/2007
Last updated
06/02/2025
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