Boullie, Patricia Ann

Boullie, Patricia Ann is an individual health care provider with primary practice located at 550 22Nd St , Astoria OR 97103-3312. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Boullie, Patricia Ann can be contacted via phone (503) 338-7595.

Contact Information

Primary practice address
550 22Nd St Astoria OR 97103-3312
Phone: (503) 338-7595
Fax: (503) 325-4905
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 096007245ZN5 Oregon

Profile Details

NPI number 1629142591
LBN Legal business name Boullie, Patricia Ann
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 20th, 2006
Last updated Mar 7th, 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 1629142591 NPPES
Oregon Other 096009245ZN5 NURSING LICENSE NUMBER
Oregon MEDICAID 83621 NURSING LICENSE NUMBER
Oregon MEDICAID 9618216 NURSING LICENSE NUMBER

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