Jennifer Boileau

Key facts

NPI

1639201528

Entity type

Individual (NPI type 1)

Primary specialty

Personal Care Attendant 3747P1801X

Practice address

31950 Clark St
New Haven, MI 48048-1934

Phone

(810) 388-1200

NPI assigned

Mar 9, 2007

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639201528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 FITZ RD",
            "city": "WALES",
            "state": "MI",
            "postal_code": "480273600",
            "telephone_number": "810-388-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31950 CLARK ST",
            "city": "NEW HAVEN",
            "state": "MI",
            "postal_code": "480481934",
            "telephone_number": "810-388-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOILEAU",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in New Haven, MI · Personal Care Attendant in Michigan