Boudreaux, Jennifer Katharine

Boudreaux, Jennifer Katharine is an sole proprietor health care provider with primary practice located at 33 N Central Ave Ste 317 , Medford OR 97501-5939. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Boudreaux, Jennifer Katharine can be contacted via phone (541) 227-2808.

Contact Information

Primary practice address
33 N Central Ave Ste 317 Medford OR 97501-5939
Phone: (541) 227-2808
Fax: (541) 227-2807
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 201350098NP Oregon
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 201350098NP Oregon

Profile Details

NPI number 1790038495
LBN Legal business name Boudreaux, Jennifer Katharine
Credentials MSN, CPNP-PC, PMHS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 18th, 2012
Last updated Nov 28th, 2023 - about 3 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 1790038495 NPPES
Oregon MEDICAID 500657026

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