Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. EDMUND A BOULEY, CNS
ActiveMR. EDMUND A BOULEY, CNS is a Psychiatric/Mental Health, Community CNS healthcare provider located in FAIRMONT, Minnesota. NPI 1831286731 is currently active in the NPPES registry. Verify at CMS.
Psychiatric/Mental Health, Community CNS · FAIRMONT, MN
Registration Details
- NPI Number
- 1831286731
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 10, 2006 (19.802276835319 yrs)
- Last Updated
- Jun 14, 2012
- Licenses
-
723743 (TX)723743 (TX)R178506-5 (MN)
Practice Information
- Address
-
1420 N STATE STFAIRMONT, MN, 560313619Browse MN providers · Browse ZIP 56031
- Phone
- 3202197518
- Primary Specialty
-
Psychiatric/Mental Health, Community CNS
364SP0808X
- Additional Specialty
- Psychiatric/Mental Health, Community CNS
- Additional Specialty
- Psychiatric/Mental Health, Community CNS
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.