Renella Boullion
Nurse Practitioner - Pediatrics
674 May Dr
Onalaska
, Texas 77360-5169
Renella Boullion
Nurse Practitioner - Pediatrics
674 May Dr
Onalaska
, Texas 77360-5169
(719) 966-2086
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About
Features
Specialties
- Nurse Practitioner - Pediatrics
Languages spoken
- English
Location
First Address
- Renella Boullion
- 674 May Dr
- Onalaska, TX
- Zip : 77360-5169
- Phone : (719) 966-2086
Second Address
- Renella Boullion
- 674 May Dr
- Onalaska, TX
- Zip : 77360-5169
- Phone : (719) 966-2086
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Is Renella Boullion accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP145643 | TX |
National Provider Identifier
| NPI | 1003442906 |
|---|---|
| Provider Name | Renella Boullion |
| First Address | Onalaska, TX 77360-5169 |
| Second Address | Onalaska, TX 77360-5169 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/03/2020 |
| Last Update Date | 03/11/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| AP145643 | (05) | TX |
| AP145643 | PRIVATE INSURANCE (01) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.