Boudreau, Andrew Gerard

Boudreau, Andrew Gerard is an individual health care provider with primary practice located at 580 W College Ave , Marquette MI 49855-2705. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Boudreau, Andrew Gerard can be contacted via phone (906) 225-4531.

Contact Information

Primary practice address
580 W College Ave Marquette MI 49855-2705
Phone: (906) 225-4531
Fax: (906) 225-4807
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4704174895 Michigan

Profile Details

NPI number 1053330738
LBN Legal business name Boudreau, Andrew Gerard
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Feb 25th, 2008 - about 18 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 1053330738 NPPES
Michigan MEDICAID 4958447

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