Bouda, Pibi Jean

Bouda, Pibi Jean is an sole proprietor health care provider with primary practice located at 3320 Marshall Ave , Saint Louis MO 63114-4344. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as his primary health care specialty. Bouda, Pibi Jean can be contacted via phone (314) 489-5537.

Contact Information

Primary practice address
3320 Marshall Ave Saint Louis MO 63114-4344
Phone: (314) 489-5537
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 2023005006 Missouri

Profile Details

NPI number 1235836982
LBN Legal business name Bouda, Pibi Jean
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 13th, 2023
Last updated Apr 26th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235836982 NPPES
Missouri MEDICAID NA

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