Bouley, Edmund A

Bouley, Edmund A is an individual health care provider with primary practice located at 1420 N State St , Fairmont MN 56031-3619. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Bouley, Edmund A can be contacted via phone (320) 219-7518.

Contact Information

Primary practice address
1420 N State St Fairmont MN 56031-3619
Phone: (320) 219-7518
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health 163WP0808X 723743 Texas
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 364SP0808X 723743 Texas
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 364SP0808X R178506-5 Minnesota

Profile Details

NPI number 1831286731
LBN Legal business name Bouley, Edmund A
Credentials Clinical Nurse Specialist (CNS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2006
Last updated Jun 14th, 2012 - about 12 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 1831286731 NPPES
Texas Other 723743 NURSING LICENSE
Texas Other R178506-5 NURSING LICENSE

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