Bouda, Pibi Jean
Bouda, Pibi Jean is an sole proprietor health care provider with primary practice located at 3320 Marshall Ave , Saint Louis MO 63114-4344. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as his primary health care specialty. Bouda, Pibi Jean can be contacted via phone (314) 489-5537.Contact Information
Primary practice address
3320 Marshall Ave
Saint Louis MO 63114-4344
Phone: (314) 489-5537
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | 2023005006 | Missouri |
Profile Details
| NPI number | 1235836982 |
|---|---|
| LBN Legal business name | Bouda, Pibi Jean |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 13th, 2023 |
| Last updated | Sep 27th, 2026 - about 12.197280092593 days ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235836982 | NPPES |
| Missouri | MEDICAID | NA |
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