Individual provider · Type 1 NPI

Cierra Jean Boutelle

Student in an Organized Health Care Education/Training Program · Oshkosh, WI

NPI number 1164137972 Active

Practice location

4391 Soda Creek Rd Apt 4
Oshkosh, WI 54901-1149

Call (608) 290-3418 Map

Specialties and licenses

TaxonomyCodeLicense
Athletic Trainer 2255A2300XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1164137972

Cierra Jean Boutelle's National Provider Identifier is 1164137972, issued on Jan 16, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Oshkosh, WI. The record was last updated on Jan 16, 2023.