J BOATMAN LLC NPI 1003112558

NPI Information

NPI: 1003112558
Provider Name: J BOATMAN LLC
Classification: Registered Nurse - 163WP0809X
Entity Type: Organization

Specialization: Psychiatric/Mental Health, Adult

Address:
11475 OLDE CABIN RD STE 120
CREVE COEUR, MO
ZIP 63141
Phone: (314) 647-4488
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J BOATMAN LLC is a psychiatric/mental health and adult registered nurse in Creve Coeur, MO. J BOATMAN LLC NPI is 1003112558. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11475 OLDE CABIN RD STE 120
CREVE COEUR, MO
ZIP 63141-128
Phone: (314) 647-4488
Fax: (314) 647-6305

The provider's authorized official is Jeffrey Boatman .
The authorized official title is Owner and has the following contact phone number (314) 753-5184.

The enumeration date for this NPI number is 2/1/2011 and was last updated on 10/10/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WP0809X	Registered Nurse	Psychiatric/Mental Health, Adult	11805	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	580714	OTHER	MISSOURI	ANTHEM BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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