Jeanne M Boudrieau, ARNP
Nurse Practitioner, Family in Lacey, WA. Individual provider (NPI-1).
NPI number1669445359
StatusActive
Last updated in NPPESFeb 27, 2014
Details
- NPI
- 1669445359
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Jeanne M Boudrieau
- Credential
- ARNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 11, 2006
- Last updated
- Feb 27, 2014
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | ap30004530 | WA | Yes |
Practice location
1450 Northwest Ln SeProvidence St. Peter Clinic At Panorama
Lacey, WA 98503-6908
Phone 360-491-4460 · Fax 360-491-3090
Mailing address
1450 Northwest Ln SeProvidence St. Peter Clinic At Panorama
Lacey, WA 98503-6908
Phone 360-491-4460 · Fax 360-491-3090
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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