MS. MARY ELLEN BOUDREAU (NPI# 1730523598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730523598 |
| Entity Type | Individual |
| Full Name | MS. MARY ELLEN BOUDREAU |
| Credential | NP (AGPCNP-BC) |
| Practice Address |
790 E Columbia St Mason MI 48854-1387 |
| Practice Telephone | 5172440120 |
| Mailing Telephone | 5172440120 |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2014-01-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
6801065539 | MI | Behavioral Health & Social Service Providers |
| N | 163WC1500X |
Registered Nurse Specialization: Community Health |
4704265711 | MI | Nursing Service Providers |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
4704265711 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902259054 | Mary Boudreau | Registered Nurse | 800 Cummings Ctr, Suite 364-u, Beverly, MA 01915-6175 | 2016-07-13 |
| 1912371337 | Mary Boudreau | Occupational Therapy Assistant | 279 Cabot St, Holyoke, MA 01040-3139 | 2015-11-23 |
| 1356741243 | Mary Boudreau | Counselor | 5965 S 900 E, Murray, UT 84121-1720 | 2014-08-27 |
| 1447591680 | Mary E Boudreau | Nurse Practitioner | 24 Stevens St, Norwalk, CT 06850-3852 | 2013-03-13 |
| Street Address |
790 E COLUMBIA ST |
| City | MASON |
| State | MI |
| Zip Code | 48854-1387 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730289422 | Corinne E Stanton | Social Worker | 790 E Columbia St, Suite 1, Mason, MI 48854-1387 | 2006-09-23 |
| 1306247374 | Sarah Hutcheson | Counselor | 790 E Columbia St, Mason, MI 48854-1387 | 2014-09-10 |
| 1912256975 | Tara Jock | Physician Assistant | 790 E Columbia St, Mason, MI 48854-1387 | 2012-09-06 |
| 1548542178 | Robert Edward Jock | Physician Assistant | 790 E Columbia St, Mason, MI 48854-1387 | 2011-09-09 |
| 1013116672 | Mary Carmen Meerschaert | Internal Medicine | 790 E Columbia St, Mason, MI 48854-1387 | 2007-07-13 |
| 1972603041 | William Charles Trowbridge | General Practice | 790 E Columbia St, Mason, MI 48854-1387 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669919205 | Michael Metcalf | Behavior Technician | 3470 Josephine Lane, Mason, MI 48854 | 2017-01-20 |
| 1891160511 | Carol Heckaman | Social Worker | 818 Charrington Ct., Mason, MI 48854 | 2015-12-07 |
| 1730588765 | Katherine Reeber | Social Worker | 2950 W Howell Rd, Mason, MI 48854 | 2014-08-14 |
| 1417383746 | Melissa F Baker | Counselor | 855 Eaton Drive, Mason, MI 48854 | 2013-09-18 |
| 1881940922 | Jennifer K Ogle | Social Worker | 118 W Oak St Ste 202, Mason, MI 48854 | 2012-07-26 |
| 1326260944 | Douglas W Gray Dds | Dentist | 230 S Temple St, Mason, MI 48854 | 2007-05-03 |
| 1043378185 | Timothy Joseph Zielinski | Dentist | 640 Wash, Mason, MI 48854 | 2006-12-04 |
| 1578635470 | Barbara Ann Begian | Physician Assistant | 790 East Columbia, Care Free Medical Inc, Mason, MI 48854 | 2006-11-15 |
| 1528015336 | University Rehabilitation Alliance, Inc. | Custodial Care Facility | 3181 Sandhill Rd., Mason, MI 48854 | 2006-05-27 |
| 1669428827 | Jeffrey Scott Deweerd | Family Medicine | 710 Temple St, Mason, MI 48854 | 2006-05-26 |
| Find all providers in zip 48854 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447859731 | Cindy Clare Craig | Nurse Practitioner | 4142 Cranberry Ln, Williamsburg, MI 49690-8641 | 2020-10-19 |
| 1487269536 | Christiane Ines Atowo | Nurse Practitioner | 25420 5 Mile Rd, Redford, MI 48239-3837 | 2020-09-14 |
| 1760095137 | Gina Louise Bennett | Nurse Practitioner | 4871 Harwood Rd, Ionia, MI 48846-9422 | 2020-08-26 |
| 1356953756 | John Westley Mailey Jr. | Nurse Practitioner | 27645 Albert St, Novi, MI 48374-1012 | 2020-08-18 |
| 1356951305 | Michelle Lynn Andriacchi | Nurse Practitioner | 45690 Kenmore St, Shelby Township, MI 48317-4656 | 2020-08-05 |
| 1124646476 | Chand Sheoran | Nurse Practitioner | 3040 Albany Ct, Troy, MI 48083-2595 | 2020-07-13 |
| 1104449214 | Lynn Marie Alexanders-klima | Nurse Practitioner | 6697 Summerdale Ct E, Ypsilanti, MI 48197-6140 | 2020-05-22 |
| 1326660580 | Kristin A Furwa | Nurse Practitioner | 600 Health Park Blvd Ste H, Grand Blanc, MI 48439-2558 | 2020-05-11 |
| 1700412582 | Ashley Ruth Zimmerman | Nurse Practitioner | 6223 Brant Ln, Ypsilanti, MI 48197-8742 | 2020-03-12 |
| 1992339139 | Afusat Ahmed | Nurse Practitioner | 5231 Madison Ave Apt A5, Okemos, MI 48864-1172 | 2020-02-26 |
| Find all providers with the same taxonomy | ||||
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| 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.