NPI 1124753041

Juanita Gail Boughers

Practitioner Attendant Care Provider Belle Rive, IL

Practice location

Address: 405 S Main St, Belle Rive, IL 62810-1228
Phone: (618) 316-1626
Mailing address: 1026 N 7th St, Mount Vernon, IL 62864-3334

Registered specialties

Attendant Care Provider Primary

Nursing Service Related Providers Taxonomy 3747A0650X

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Registry record

NPI: 1124753041
Entity type: Individual
Sex (as registered): Female
NPI issued: 24 Jul 2022
Record last updated: 24 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.