| Doctor Name: | MRS. TERESA FAYE BOUDRIE |
| NPI Number: | 1053541326 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 130082 |
| Business Practice Address: | 650 Joel Dr Fort Campbell, KY - 422235318 |
| Business Phone Number: | 2707988500 |
| Business Fax Number: | 2707988666 |
| Mailing Address: | 9215 Elkhorn Rd, SPRINGVILLE |
| State: | TN |
| Postal Code: | 382564962 |
| Phone Number: | 7313362598 |
| Fax Number: | |
| NPI Enumeration Date: | 07/21/2009 |
| NPI Last Update Date: | 07/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WE0003X |
| License Number: | 130082 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Emergency |
| Taxonomy Definition: | |