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JENNIFER KATHARINE BOUDREAUX MSN, CPNP-PC, PMHS
NPI 1790038495
Nurse Practitioner - Pediatrics in Medford, OR

Active since October 18, 2012
33 N CENTRAL AVE STE 317, MEDFORD, OR 97501(541) 227-2808(541) 227-2807 Get Directions Write a Review

NPPES record last updated: November 28, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 23, 2022, Nov 15, 2021, Feb 15, 2021 (3 updates tracked since 2021).

About Jennifer Katharine Boudreaux Msn, Cpnp-pc, Pmhs NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNIFER KATHARINE BOUDREAUX MSN, CPNP-PC, PMHS (NPI 1790038495) is an individual pediatrics provider in Medford, Oregon, licensed in Oregon (201350098NP) and active in the NPI registry since October 2012.

NPPES Registry Identity

NPI1790038495
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameJENNIFER KATHARINE BOUDREAUXCredential: MSN, CPNP-PC, PMHS
Location Address33 N CENTRAL AVE STE 317Medford, OR 97501-5939
Mailing Address104 Cherrybark DrJacksonville, NC 28540-9360 · (541) 324-3648 · Fax (541) 227-2807
Phone(541) 227-2808
Fax(541) 227-2807
Sole ProprietorYes
Enumeration DateOctober 18, 2012
Last NPPES UpdateNovember 28, 20233 updates tracked since enumeration
NPPES CertifiedNovember 28, 2023
✔ NPI 1790038495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in OR · 201350098NP
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X · License 201350098NP (OR)
33 N CENTRAL AVE STE 317, Medford, OR 97501
Open in Google Maps ↗

Other Identifiers 1

Medicaid500657026OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and more.Insurance ›

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PEDIATRIC NEURODEVELOPMENTAL & BEHAVIORAL CLINIC OF SOUTHERN OREGON
Community/Behavioral Health
33 N CENTRAL AVE STE 317
MEDFORD, OR 97501
Jackson County (541) 227-2808

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jennifer Boudreaux's NPI number?

The NPI number for Jennifer Boudreaux is 1790038495. It was assigned to this individual provider in the NPPES registry on October 18, 2012.

Where is Jennifer Boudreaux located?

Jennifer Boudreaux practices at 33 N Central Ave Ste 317, Medford, OR 97501. The listed phone number is (541) 227-2808.

What is Jennifer Boudreaux's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

What insurance does Jennifer Boudreaux accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Jennifer Boudreaux as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jennifer Boudreaux was last updated on November 28, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.