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LEIANE MOORE BOUDREAU ARNP

>> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1588833958

Individual Registrant:
 LEIANE MOORE BOUDREAU ARNP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1301 PLANTATION ISLAND DR S SUITE 106A SAINT AUGUSTINE, FL 32080-3108 US
Tel: 904-460-9191  Fax: 904-471-4859

Contact information for business:
1301 PLANTATION ISLAND DR S SUITE 106A SAINT AUGUSTINE, FL 32080-3108 US
Tel: 904-460-9191  Fax: 904-471-4859

Registration Information:
NPI: 1588833958
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
FLARNP2514302

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS FL - Page 1



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