Doctor Name: | TINA BUDREAU |
NPI Number: | 1003990896 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | 061966 |
Business Practice Address: | 638 S Bluff Blvd Clinton, IA - 527324742 |
Business Phone Number: | 5632435633 |
Business Fax Number: | 5632439567 |
Mailing Address: | 638 S Bluff Blvd, CLINTON |
State: | IA |
Postal Code: | 527324742 |
Phone Number: | 5632435633 |
Fax Number: | 5632439567 |
NPI Enumeration Date: | 10/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | 061966 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |