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Individual
MS. KIMBERLY RENEE BOUCHARD
Active
Individual
MS. KIMBERLY RENEE BOUCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, AEMT
Taxonomy
Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
1645682
MI
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
4704305934
MI
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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