Kristin Diane Boudreau, D.AC., L.AC.
Individual provider Active NPI Acupuncturist · Middletown, RI
NPI 1992011480 · NPPES record last updated Aug 23, 2010
Key facts
- NPI
- 1992011480
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acupuncturist 171100000X
- License
- DA00363 (RI)
- Practice address
- 126 W Main Rd
Middletown, RI 02842-4937 - Phone
- (877) 482-7896
- Fax
- (877) 283-0678
- NPI assigned
- Aug 23, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC13182 | CA | MD | Acupuncturist |
| DA00363 | RI | MD | Acupuncturist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | DA00363 | RI | Yes |
| Acupuncturist | 171100000X | AC13182 | CA |
Addresses
Primary practice location
126 W Main Rd
Middletown, RI 02842-4937
Mailing address
49 Ward Ave
Middletown, RI 02842-5511
Phone (401) 339-8049
Other providers in Middletown, RI
- Guerrino Boni
- Megan Booher
- Susan M Bordonaro
- David Boscia
- Ashley Botelho
- Michelle A Boyle
- Gwynne A Bragdon
- Branches of Birth LLC
- Mary Lou Brawn
- Bridges Inc
All providers in Middletown, RI · Acupuncturist in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.