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Individual
LESLIE JEAN BOUCHERLE
Active
Individual
LESLIE JEAN BOUCHERLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-08357
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043793789
—
NC
01
—
200R1
BCBS NC
NC
01
—
CS2404500385
CARESOURCE
NC
01
—
NN4763B
MEDICARE
NC
01
—
Q00092493
RAILROAD MEDICARE
NC
Enumeration date
09/10/2018
Last updated
04/14/2025
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