Individual provider · Type 1 NPI
Nicole M. Boudreaux, PA-C
Medical Physician Assistant · Princess Anne, MD
NPI number
1699231894
Active
Practice location
12302 Somerset Ave Ste Ab
Princess Anne, MD 21853-3099
Mailing address
34 Gatehouse Trl
Berlin, MD 21811-2023
Other practice locations
- 205 S Division St, Salisbury, MD 21801-4930 · (443) 944-9896
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | C0007122 (MD) |
| Emergency Medicine Physician | 207P00000X | C0007122 (MD) |
Medical Physician Assistant: Definition to come...
2 other providers at this address
Other medical physician assistant providers in Princess Anne
About NPI 1699231894
Nicole M. Boudreaux, PA-C's National Provider Identifier is 1699231894, issued on Feb 13, 2019. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Princess Anne, MD. The record was last updated on Dec 27, 2023.