Boudreau, Leiane Moore

Boudreau, Leiane Moore is an individual health care provider with primary practice located at 1301 Plantation Island Dr S Suite 106A, Saint Augustine FL 32080-3108. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Boudreau, Leiane Moore can be contacted via phone (904) 460-9191.

Contact Information

Primary practice address
1301 Plantation Island Dr S Suite 106A Saint Augustine FL 32080-3108
Phone: (904) 460-9191
Fax: (904) 471-4859
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP2514302 Florida

Profile Details

NPI number 1588833958
LBN Legal business name Boudreau, Leiane Moore
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 29th, 2008
Last updated Jan 5th, 2015 - about 11 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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