DR. ELLEN FLORENCE BOUDREAU (NPI# 1053325621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053325621 |
| Entity Type | Individual |
| Full Name | DR. ELLEN FLORENCE BOUDREAU |
| Credential | M.D. |
| Practice Address |
6405 Cardinal Ln Columbia MD 21044-4020 |
| Practice Telephone | 3014527115 |
| Mailing Telephone | 3014527115 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2017-01-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | D0035540 | MD | Other Service Providers |
| Street Address |
6405 CARDINAL LN |
| City | COLUMBIA |
| State | MD |
| Zip Code | 21044-4020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699331 | Brightview Columbia, LLC | Alzheimer Center (Dementia Center) | 6670 Martin Road, Columbia, MD 21044 | 2020-11-03 |
| 1689291544 | Diana Matthews | Physical Therapist | 6016 Jerrys Drive, Columbia, MD 21044 | 2020-06-26 |
| 1902380926 | Bagiwa Healthcare Services LLC | Nursing Care | 10630 Little Patuxent Park Way, Suite 314i, Colombia, MD 21044 | 2018-09-17 |
| 1295228245 | April Bloom Assisted Living, LLC | Assisted Living Facility | 5037 East Durham Rd, Columbia, MD 21044 | 2018-06-13 |
| 1437659562 | La Shawna A Obame | Counselor | 10451 Twin Rivers Rd Ste 100, Columbia, MD 21044 | 2018-02-15 |
| 1205335262 | Rashida Annette Winestock | Registered Nurse | 10440 Little Patuxent Pkwy 800, Columbia, MD 21044 | 2018-02-06 |
| 1215436274 | Terri Lynn Buzby | Registered Nurse | 10440 Little Patuxuent Pkwy 800, Columbia, MD 21044 | 2018-02-06 |
| 1134628191 | Sarah Elizabeth Stiltner | Registered Nurse | 10440 Little Patuxent Pkwy Suite 800, Columbia, MD 21044 | 2018-02-06 |
| 1326547381 | David Oliver Sloan Jr. | Registered Nurse | 10440 Little Patuxent Parkway Suite 800, Columbia, MD 21044 | 2018-02-06 |
| 1467950980 | Jill Sheppard Davenport | Nutritionist | 10801 Hickory Ridge Rd Suite 215, C/o Holistic Child Psychiatry, Columbia, MD 21044 | 2018-01-30 |
| Find all providers in zip 21044 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518498443 | Samantha Panuski | Military Health Care Provider | 6439 Garners Ferry Rd, Columbia, SC 29209-1638 | 2017-03-22 |
| 1568500676 | Buffy Howard | Military Health Care Provider | 6439 Garners Ferry Rd, Columbia, SC 29209-1638 | 2007-02-01 |
| 1912095423 | Paul Sanders | Military Health Care Provider | 4500 Stuart St, Moncrief Army Community Hospital/credentials, Columbia, SC 29207-5700 | 2006-10-10 |
| 1477644722 | Marc J Stevens | Military Health Care Provider | 4500 Stuart St, Moncrief Army Community Hospital/credentials, Columbia, SC 29207-5700 | 2006-09-28 |
| 1679673156 | Sejal Patel | Military Health Care Provider | 4500 Stuart St, Moncrief Army Community Hospital/credentials, Columbia, SC 29207-5700 | 2006-09-24 |
| 1346346624 | Juliana Infante Galang | Military Health Care Provider | 4500 Stuart St, Moncrief Army Community Hospital Att: Mcxl-pq, Columbia, SC 29207-5700 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669079604 | Jessica Yvonne Thomas | Military Health Care Provider | 64 Verdant Oak Aly, Clarksburg, MD 20871-3504 | 2020-10-02 |
| 1740801588 | Matildah A Mchatta | Military Health Care Provider | 19902 Sweetgum Cir Apt 42, Germantown, MD 20874-3770 | 2020-05-04 |
| 1851927859 | Samira Wrightson | Military Health Care Provider | 5701 Granby Rd, Derwood, MD 20855-1412 | 2020-03-21 |
| 1578199535 | Ebony Andrea Peterman | Military Health Care Provider | 4915 Hampden Ln Unit 103, Bethesda, MD 20814-3699 | 2020-03-20 |
| 1346723012 | Bivor Shrestha | Military Health Care Provider | 546 Salisbury Pl, Prince Frederick, MD 20678-3152 | 2018-09-10 |
| 1861974990 | Suzanna Hopkins | Military Health Care Provider | 4301 Jones Bridge Rd Rm 1040, Bethesda, MD 20814-4799 | 2018-09-05 |
| 1104346436 | Darrell J Fisher | Military Health Care Provider | 7903 Crows Nest Court, Laurel, MD 20707 | 2017-06-27 |
| 1346760634 | Laura Christine Barba-ruiz | Military Health Care Provider | 8901 Rockville Pike Internal Medicine, Bethesda, MD 20889-0001 | 2017-06-27 |
| 1477936235 | Anna Marie Pepe | Military Health Care Provider | 15601 Barnesville Rd, Boyds, MD 20841-9403 | 2015-06-29 |
| 1487984233 | Suzanne Marie Gillern | Military Health Care Provider | 10157 Sutherland Rd, Silver Spring, MD 20901-2421 | 2009-12-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.