Provider Demographics
NPI:1124643762
Name:BOAYUE, JULIEN K (RN)
Entity type:Individual
Prefix:MS
First Name:JULIEN
Middle Name:K
Last Name:BOAYUE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 DOUGLAS DR N STE 224N
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4360
Mailing Address - Country:US
Mailing Address - Phone:612-377-1589
Mailing Address - Fax:844-658-3241
Practice Address - Street 1:1710 DOUGLAS DR N STE 224N
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4360
Practice Address - Country:US
Practice Address - Phone:763-377-1589
Practice Address - Fax:844-658-3241
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR130753-7163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse