Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum Sole proprietor

Jennifer Katharine Boudreaux, MSN, CPNP-PC, PMHS

Pediatric Nurse Practitioner in Medford, OR · enumerated 2012 · practices at Pediatric Neurodevelopmental & Behavioral Clinic of Southern Oregon.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1790038495

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Registry record

Entity type Individual (Type 1)

Name Jennifer Katharine Boudreaux

Credential MSN, CPNP-PC, PMHS

Sex Female

Practice address Medford, OR, 97501

Phone (541) 227-2808

Fax (541) 227-2807

Enumeration date Oct 18, 2012

Last updated in NPPES Nov 28, 2023

Street address withheld: NPPES sole-proprietor addresses can be home addresses. See our data policy.

Taxonomy & licenses

363LP0808X Psychiatric/Mental Health Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers · License 201350098NP (OR) Secondary

363LP0200X Pediatric Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers · License 201350098NP (OR) Primary

Other identifiers

Identifier	Type	State	Issuer
500657026	Medicaid	OR	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where does Jennifer Boudreaux practice?

The practice location on file with NPPES is in Medford, OR. Providers can have multiple locations; NPPES lists the primary practice address.

What is the NPI number for Jennifer Boudreaux?

The National Provider Identifier (NPI) for Jennifer Boudreaux is 1790038495, a Type 1 (individual) record in the CMS NPPES registry.

Other providers at this practice address

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Pediatric Neurodevelopmental & Behavioral Clinic of Southern Oregon Community/Behavioral Health Agency · Medford, OR NPI 1619791415

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2023-11-28.