RENELLA BOULLION APRN FNP-BC NPI 1003442906

NPI Information

  • NPI: 1003442906
  • Provider Name: RENELLA BOULLION, APRN, FNP-BC
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • Address: 400 OGLETREE DR
    LIVINGSTON, TX
    ZIP 77351
  • Phone: (936) 328-8812

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NPI Details

Renella Boullion, APRN, FNP-BC is a pediatrics nurse practitioner in Livingston, TX. Renella Boullion, APRN, FNP-BC NPI is 1003442906. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

400 OGLETREE DR
LIVINGSTON, TX
ZIP 77351-783
Phone: (936) 328-8812

The enumeration date for this NPI number is 3/23/2020 and was last updated on 7/14/2022.

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
1363LP0200XNurse PractitionerPediatricsAP145643TEXASYes

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
1AP145643MEDICAIDTEXAS
2AP145643OTHERTEXASPRIVATE INSURANCE

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: 11/21/2025

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