Melinda Boudreau

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11041605 Issued in FL

Practice address

12635 Evington Point Dr
Riverview, FL 33579-4060

Phone

(813) 394-7907

NPI assigned

Aug 13, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Melinda Walser-Boudreau Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1755043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1912883265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12635 EVINGTON POINT DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335794060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12635 EVINGTON POINT DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335794060",
            "telephone_number": "813-394-7907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAU",
        "first_name": "MELINDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-13",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11041605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELINDA",
            "last_name": "WALSER-BOUDREAU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amber Booz
• Danielle Abbie Borland, APRN
• Janna R Borowicz
• Hanna A Bostwick, DMD
• Joslyn Courtney Bouche
• Brianna Bounds, BEHAVIOR TECHNICIAN
• Sheila Boussiquot
• Mina Boutros
• Stephanie Grace Bowen, CRNA
• Grace Michelle Bowman, BEHAVIOR TECHNICIAN

• Nurse Practitioner in Riverview, FL
• Providers in Riverview, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.