Angela Boutin, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

302098 Issued in WI

Practice address

120 Meadow LN
West Salem, WI 54669-9263

Phone

(608) 385-4492

NPI assigned

Jan 20, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Angela Jean Krarup Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1114679149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MEADOW LN",
            "city": "WEST SALEM",
            "state": "WI",
            "postal_code": "546699263",
            "telephone_number": "608-385-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MEADOW LN",
            "city": "WEST SALEM",
            "state": "WI",
            "postal_code": "546699263",
            "telephone_number": "608-385-4492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTIN",
        "first_name": "ANGELA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "302098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "KRARUP",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristin Patricia Barth, CRNA
• Mary Clare Becks, MT-BC, NMT, WMTR
• Erica Boland, D.C.
• Kyle David Boland, D.C.
• Karen J Bonifas, PT
• Amy Pat Brieske, RPH
• Jennifer Bungartz
• Burkhardt Physical Therapy Center LLC
• Myra Marie Burkhardt, PT
• Hannah Lorraine Butler

• Licensed Practical Nurse in West Salem, WI
• Providers in West Salem, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.