Boudet, Patricia A

Boudet, Patricia A is an individual health care provider with primary practice located at 404 S Lewis Ln , Carbondale IL 62901-3547. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Boudet, Patricia A can be contacted via phone (618) 519-9200.

Contact Information

Primary practice address
404 S Lewis Ln Carbondale IL 62901-3547
Phone: (618) 519-9200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085-000668 Illinois

Profile Details

NPI number 1841237120
LBN Legal business name Boudet, Patricia A
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated Mar 17th, 2018 - about 8 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841237120 NPPES
Illinois MEDICAID 370966854024
Illinois Other 085-000668

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