Jenna Boudreaux
Community Health Worker in Florissant, MO. Individual provider (NPI-1).
NPI number1356992010
StatusActive
Last updated in NPPESSep 24, 2019
Details
- NPI
- 1356992010
- Entity type
- Individual (NPI-1)
- Name
- Jenna Boudreaux
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 24, 2019
- Last updated
- Sep 24, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172V00000X | Community Health Worker | – | – | Yes |
Practice location
1150 Graham Rd Ste 101Florissant, MO 63031-8077
Phone 314-206-3900
Mailing address
1430 Olive St Ste 400Saint Louis, MO 63103-2303
Phone 314-206-3700
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