Provider Demographics
NPI:1689470460
Name:BOUDREAU, HOPE ANGIE
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:ANGIE
Last Name:BOUDREAU
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 N KNIFFIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:OH
Mailing Address - Zip Code:44837-1125
Mailing Address - Country:US
Mailing Address - Phone:419-554-4552
Mailing Address - Fax:
Practice Address - Street 1:38 N KNIFFIN ST
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:OH
Practice Address - Zip Code:44837-1125
Practice Address - Country:US
Practice Address - Phone:419-554-4552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker