# MRS. KAREN A. BOUCHARD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1083889273
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 005305 | GA | Yes |

## Other

- **Enumeration date:** 04/28/2008
- **Last updated:** 09/10/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01299269 | AMERIGROUP | — |
| 05 | — | 357708693A | — | GA |