Individual
ANDREA BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
194 E MAIN ST, FORT KENT, ME 04743-1428
(207) 834-3155
(207) 834-2949
Mailing address
194 E MAIN ST, FORT KENT, ME 04743-1428
(207) 834-3155
(207) 834-2949
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA163028
ME
390200000X
Student in an Organized Health Care Education/Training Program
RN57585
ME
Other
Enumeration date
02/13/2016
Last updated
11/30/2019
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