Allan Boudreaux, MSN, RN, CCNS, CEN

Primary specialty

Emergency Clinical Nurse SpecialistTaxonomy code 364SE0003X

License

793185 Issued in TX

Practice address

3851 Roger Brooke Dr.
McHe-QD (Creds), Brooke Army Medical Center
Fort Sam Houston, TX 78234-6200

Phone

(210) 916-3390

NPI assigned

Jan 21, 2011

Sex

Male

Sole proprietor

Yes

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

Master of Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295568000000",
    "number": "1982909024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 ROGER BROOKE DR., MCHE-QD (CREDS)",
            "address_2": "BROOKE ARMY MEDICAL CENTER",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782346200",
            "telephone_number": "210-916-3390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 ROGER BROOKE DR.",
            "address_2": "MCHE-QD (CREDS), BROOKE ARMY MEDICAL CENTER",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782346200",
            "telephone_number": "210-916-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "ALLAN",
        "name_prefix": "Mr.",
        "credential": "MSN, RN, CCNS, CEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-21",
        "last_updated": "2011-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SE0003X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Emergency",
            "state": "TX",
            "license": "793185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Booker
• Melissa Sanchez Boone, PA
• Paul Boquet, DDS
• Matthew Arnold Borgman, M.D.
• Samantha Quinne Borrelli, PA-C
• Sean Marcel Boulanger, DPT
• Derrick Paul Bouldin Jr., PA-C
• Evan Boullosa, LPTA
• Jason Henry Boulter, MD
• Cynthia Alfaro Bourne, PT, DPT

• Clinical Nurse Specialist in Fort Sam Houston, TX
• Providers in Fort Sam Houston, TX by specialty
• Clinical Nurse Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; 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.