IndividualActive
Jennifer Boudreaux, MSN, CPNP-PC, PMHS
NPI 1790038495 · Pediatric Nurse Practitioner · Medford, OR
Provider details
- NPI number
- 1790038495
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- MSN, CPNP-PC, PMHS
- Sex
- Female
- Sole proprietor
- Yes
- License
- 201350098NP (OR)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
33 N Central Ave Ste 317
Medford, OR 97501-5939
Phone: (541) 227-2808
Fax: (541) 227-2807
Approximate (ZIP-level) locationGet directions
Mailing address
104 Cherrybark Dr
Jacksonville, NC 28540-9360
Registry dates
- Enumerated
- 2012-10-18
- Last updated
- 2023-11-28
- Certified
- 2023-11-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.