Elizabeth N Boulette, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

051734 Issued in CA

Practice address

34800 Bob Wilson Dr
San Diego, CA 92134-1098

Phone

(619) 532-8951

NPI assigned

Oct 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1164506366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11344 PENANOVA ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921291028",
            "telephone_number": "858-672-9634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "619-532-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULETTE",
        "first_name": "ELIZABETH",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "051734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Katherine Bougetz, PHARM.D.
• Genevieve Boulais, MA CCC-SLP
• Daniel Lee Bouland, M.D.
• Marc Patrick Boulanger II, DNP, PMHNP-BC
• Meagan Bouldin, RN BSN
• Boulevard Dental Center
• Joseph Boulos, DDS
• Julie Elaine Boulos, DDS
• Giscard Boulou
• Katelynn Bouma

• Certified Registered Nurse Anesthetist in San Diego, CA
• Providers in San Diego, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; 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.