Bouldin, Jessica Brunot
Bouldin, Jessica Brunot is an sole proprietor health care provider with primary practice located at 102 Apache Trail , Winchester VA 22602-1300. She recently has 2 registered licenses in different health care specialties including Nursing Service Related Providers / Doula, Other Service Providers / Lactation Consultant, Non-RN. Other Service Providers / Lactation Consultant, Non-RN is her primary health care specialty. Bouldin, Jessica Brunot can be contacted via phone (540) 222-8700.Contact Information
Primary practice address
102 Apache Trail
Winchester VA 22602-1300
Phone: (540) 222-8700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Related Providers / Doula | 374J00000X | ||
| Other Service Providers / Lactation Consultant, Non-RN | 174N00000X | 351584 | Virginia |
Profile Details
| NPI number | 1174223358 |
|---|---|
| LBN Legal business name | Bouldin, Jessica Brunot |
| Credentials | CLC, CD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 7th, 2023 |
| Last updated | Dec 20th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174223358 | NPPES |
| Virginia | MEDICAID | 81180 |
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