TARA BOUDOIN DEVILLE (NPI# 1104184845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104184845 |
| Entity Type | Individual |
| Full Name | TARA BOUDOIN DEVILLE |
| Credential | NP |
| Practice Address |
3195 Dowlen Rd Ste 105 Beaumont TX 77706 |
| Mailing Address |
3195 Dowlen Rd Ste 105 Beaumont TX 77706-7272 |
| Practice Telephone | 4092040257 |
| Mailing Telephone | 4092040257 |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2018-06-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 712309 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3195 DOWLEN RD STE 105 |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205904174 | Thomas Britt Lackey | Nurse Practitioner | 3195 Dowlen Rd Ste 105, Beaumont, TX 77706-7272 | 2006-12-01 |
| 1841525235 | Doctors Express of The Beaumont Area Pa | Clinic/Center | 3195 Dowlen Rd Ste 105, Beaumont, TX 77706 | 2009-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982176293 | Allen Family Home Care LLC | In Home Supportive Care | 4055 Dowlen Rd Ste 112, Beaumont, TX 77706 | 2018-12-27 |
| 1730661174 | Joseph Pryor Ingram | Counselor | 5450 Folsom Road #3, Beaumont, TX 77706 | 2018-09-02 |
| 1336644582 | Jenny Lee Broaddus | Counselor | 8150 N. Major Dr., Beaumont, TX 77706 | 2018-03-29 |
| 1528584026 | Amanthia Peace Williams | Pedorthist | 3645 Calder Ave., Beaumont, TX 77706 | 2017-08-16 |
| 1356863286 | Nicole Denise Williams | Speech-Language Pathologist | 970 North 23rd Street, Beaumont, TX 77706 | 2017-07-12 |
| 1487038923 | Associates for Dental Health, Pllc | Dentist | 415 Dowlen Rd Ste A, Beaumont, TX 77706 | 2015-07-15 |
| 1508264532 | Rose Anne Essex | Dietitian, Registered | 3510 Charleston Ln, Beaumont, TX 77706 | 2014-12-08 |
| 1780001933 | C. Asteris, Inc. | Contractor | 1465 W. Lucas Dr., Beaumont, TX 77706 | 2014-03-26 |
| 1376985820 | Erica J Hayes M D P A | Preferred Provider Organization | 4a Bayou Brandt Drive, Beaumont, TX 77706 | 2013-07-25 |
| 1194162909 | Hezron Omanga | Pharmacist | 3585 N. Dowlen Road, Beaumont, TX 77706 | 2013-06-03 |
| Find all providers in zip 77706 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437614641 | Matthew Carter | Nurse Practitioner | 3030 North St Ste 460, Beaumont, TX 77702-1499 | 2019-02-01 |
| 1598272338 | Kare Infusion Center LLC | Nurse Practitioner | 6755 Phelan Blvd Ste 46, Beaumont, TX 77706-6077 | 2018-01-02 |
| 1407108715 | Garrett Benjamin Roy | Nurse Practitioner | 4347 Phelan Blvd Ste 101, Beaumont, TX 77707-2159 | 2012-10-10 |
| 1629328919 | Leslie F Anslem | Nurse Practitioner | 3080 College St., Beaumont, TX 77701-4606 | 2012-09-13 |
| 1003976531 | Lynda Marie Few | Nurse Practitioner | 3560 Delaware St # 601, Beaumont, TX 77706-3067 | 2006-12-12 |
| 1073525697 | Connie L Brown | Nurse Practitioner | 155 Ih-10 North, Ste: 1, Beaumont, TX 77707 | 2006-08-12 |
| 1508894528 | Tammy L Stout | Nurse Practitioner | 3406 College St # 100, Beaumont, TX 77701-4612 | 2006-06-29 |
| 1407884844 | Susan J Lundy | Nurse Practitioner | 3430 Fannin St, Beaumont, TX 77701-3803 | 2006-06-28 |
| 1932143351 | Emma Rachele Davis | Nurse Practitioner | 3060 Fm 3514, Beaumont, TX 77705 | 2006-06-15 |
| 1578513040 | Shawn Rooney Gray | Nurse Practitioner | 857 E. Virginia, Beaumont, TX 77705 | 2006-05-12 |
| Find all providers in BEAUMONT | ||||
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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.