Search › Wisconsin › 363A00000X
Anita Boulom, PA-C
NPI 1184213555 · on the registry since 2021
Practice
- Address
- 3400 Deerfield Dr
Janesville, WI 53546 - Phone
- (608) 314-3600
- Organisation at this address
- Mercy Health System Corporation
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 9
Additional practice sites
- 1000 Mineral Point Ave, Janesville, WI
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-01-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin