Mylene Boudreau, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

19745 Issued in SC

Practice address

75 E McBee Ave
Greenville, SC 29601-2737

Phone

(864) 241-5199

Fax

(864) 241-5198

NPI assigned

Nov 19, 2015

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St Francis Physician Services Inc

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295769438
  NPD (past)

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1356715957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743294",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743294",
            "telephone_number": "864-675-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 E MCBEE AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012737",
            "telephone_number": "864-241-5199",
            "fax_number": "864-241-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAU",
        "first_name": "MYLENE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-19",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC BOARD OF NURSING",
            "identifier": "APN.19745",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Bostick, NP
• Cara Rhodes Bostrom, M.D.
• Mark Wilson Boswell, FNP
• Jonathan Eric Botstein, M.D.
• Jamie Bott, APRN, NNP-BC
• Valerie Boughner, LMFT
• Robyn Bouie
• Chris George Boukedes, MD
• Cynthia Boulton, PHARMD
• Stephanie Bour, RN

• Family Nurse Practitioner in Greenville, SC
• Providers in Greenville, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2017; 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.