Individual
KATELIN ASHLEY BOUCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
130 COLLINS RD, BRISTOL, CT 06010-3859
(860) 919-5626
Mailing address
130 COLLINS RD, BRISTOL, CT 06010-3859
(860) 919-5626
Taxonomy
Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
9445
CT
363LF0000X
Family Nurse Practitioner
Primary
9445
CT
Other
Enumeration date
01/22/2021
Last updated
02/26/2021
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