Killman Josue Boutet, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

164849 Issued in TN

Practice address

921 East Third Street
Chattanooga, TN 37403-2165

Phone

(423) 209-8306

NPI assigned

Sep 26, 2008

Sex

Male

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)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222387200000",
    "number": "1740430768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3863 LAKE KATHY RD",
            "city": "TUNNEL HILL",
            "state": "GA",
            "postal_code": "307559716",
            "telephone_number": "706-516-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 EAST THIRD STREET",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032165",
            "telephone_number": "423-209-8306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTET",
        "first_name": "KILLMAN",
        "middle_name": "JOSUE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-26",
        "last_updated": "2008-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "164849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Registered Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; 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.