Shauneen Marie Bouthilette, R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

28199596A Issued in IN

Practice address

504 College View Dr
Elizabethtown, KY 42701-3072

Phone

(270) 723-7475

NPI assigned

Jan 24, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1327363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1891066767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 COLLEGE VIEW DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427013072",
            "telephone_number": "270-723-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 COLLEGE VIEW DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427013072",
            "telephone_number": "270-723-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTHILETTE",
        "first_name": "SHAUNEEN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-24",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28199596A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1077845",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Britt Austin Borders, OD
• Sara Rene' Borders, OD
• Kristina Marie Boshart
• Alexandria M Boswell
• Valerie Boudreaux
• David Bower, MD
• Lauren M Bowlin, NP
• Elisha Reed Bowman, CADC
• Selena Gail Boyd, PA-C
• Kaleb Boydston, MS, ATC

• Registered Nurse in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Registered Nurse in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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.