Individual
MS. KIMBERLY RENEE BOUCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, AEMT
Contact information
Practice address
3285 122ND AVE, ALLEGAN, MI 49010-9511
(269) 673-6617
(269) 686-5260
Mailing address
20 W CHERRY AVE, ZEELAND, MI 49464-1606
(616) 566-8112
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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