MYLENE BOUDREAU (NPI# 1356715957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356715957 |
| Entity Type | Individual |
| Full Name | MYLENE BOUDREAU |
| Credential | FNP |
| Practice Address |
75 E Mcbee Ave Greenville SC 29601-2737 |
| Mailing Address |
Po Box 743294 Atlanta GA 30374-3294 |
| Practice Telephone | 8642415199 |
| Practice Fax Number | 8642415198 |
| Mailing Telephone | 8646754600 |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2017-05-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
19745 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | SC BOARD OF NURSING | APN.19745 | 01 |
| Street Address |
75 E MCBEE AVE |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29601-2737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528017860 | Rico Amancio Aragon | Family Medicine | 75 E Mcbee Ave, Greenville, SC 29601-2737 | 2006-05-05 |
| 1558968552 | Khusbu Devang Desai | Nurse Practitioner | 75 E Mcbee Ave, Greenville, SC 29601-2737 | 2020-10-03 |
| 1669995825 | Taylor Anderson Mckeowen | Nurse Practitioner | 75 E Mcbee Ave, Greenville, SC 29601-2737 | 2017-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700305620 | True Sleep Diagnostics | Clinic/Center | 220 North Main St Ste 500, Pmb 104, Greenville, SC 29601 | 2017-09-12 |
| 1245786813 | Yvette Ombougno | Registered Nurse | 200 University Ridge, Greenville, SC 29601 | 2016-09-01 |
| 1477921823 | Laura Gore Siefert | Registered Nurse | 1 Saint Francis Drive, Greenville, SC 29601 | 2015-09-02 |
| 1821493826 | Sarah Fuller | Counselor | 602 Pettigru St, Greenville, SC 29601 | 2014-11-03 |
| 1689088932 | Chenille Taylor | Nurse Practitioner | 201 N. Main Street, Greenville, SC 29601 | 2014-06-15 |
| 1861827842 | Caritas Counseling Services LLC | Community/Behavioral Health | 111 Hampton Avenue, St Mary's Catholic Church, Greenville, SC 29601 | 2013-09-09 |
| 1568790335 | Lynn A. Victory | Counselor | 710 Pettigru Street, The Cottage, Greenville, SC 29601 | 2009-12-06 |
| 1386971448 | Lisa Speach | Nurse Practitioner | 3 St. Francis Drive, Suite 300, Greenville, SC 29601 | 2009-11-11 |
| 1851528418 | Adam Shawn Riffle | Specialist/Technologist | 175 Patewood Drive, Greenville, SC 29601 | 2009-06-22 |
| 1114178332 | Margaret W. Lee | Psychologist | 412 Pettigru St., Suite C, Greenville, SC 29601 | 2008-10-07 |
| Find all providers in zip 29601 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285234237 | Vb Medical Group LLC | Nurse Practitioner | 10047 Whispering Wind Dr, Greenville, IN 47124-9704 | 2020-10-29 |
| 1700403276 | Carolyn Lisa Fry | Nurse Practitioner | 500 Baylor Dr Apt Suite, Greenville, TX 75402-8005 | 2020-07-01 |
| 1033744701 | Jennifer C Carpenter | Nurse Practitioner | 2018 County Road 3318, Greenville, TX 75402-5268 | 2020-03-03 |
| 1659904183 | Joante Kirk | Nurse Practitioner | 1699 S Main St, Greenville, MS 38701-7364 | 2020-02-12 |
| 1578103859 | Michelle Earley | Nurse Practitioner | 4221 Ridgecrest Rd Ste 107, Greenville, TX 75402-6015 | 2020-01-14 |
| 1871138149 | Paola Andrea Mora Tobon | Nurse Practitioner | 200 Patewood Dr Ste 320, Greenville, SC 29615-3593 | 2019-11-11 |
| 1144863895 | Rashemia Latricia Suber | Nurse Practitioner | 814 Riviera Cir N, Greenville, MS 38701-8029 | 2019-10-25 |
| 1003460569 | Shaun Fitzpatrick | Nurse Practitioner | Physicians East, Pa 1850 W. Arlington Blvd., Greenville, NC 27834 | 2019-08-01 |
| 1487116745 | Megan Rogers Semanski | Nurse Practitioner | 890 W Faris Rd Ste 510, Greenville, SC 29605-4286 | 2019-04-04 |
| 1053884247 | Renee L Bridges | Nurse Practitioner | 10 Enterprise Blvd Ste 202, Greenville, SC 29615-3554 | 2019-01-10 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29601 |
Please comment or provide details below to improve the information on MYLENE BOUDREAU.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.