Provider Demographics
NPI:1306925987
Name:BOUDREAUX, CARMEN JULIA (RN)
Entity type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:JULIA
Last Name:BOUDREAUX
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 1:313 COUNTY ROAD 4711
Mailing Address - Street 2:
Mailing Address - City:KEMPNER
Mailing Address - State:TX
Mailing Address - Zip Code:76539-5867
Mailing Address - Country:US
Mailing Address - Phone:254-288-8096
Mailing Address - Fax:245-288-8970
Practice Address - Street 1:313 COUNTY ROAD 4711
Practice Address - Street 2:
Practice Address - City:KEMPNER
Practice Address - State:TX
Practice Address - Zip Code:76539-5867
Practice Address - Country:US
Practice Address - Phone:254-288-8096
Practice Address - Fax:245-288-8970
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX637840163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator