Individual
MS. KERRI L BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP-BC
Contact information
Practice address
16 S EUTAW ST FL 3, BALTIMORE, MD 21201-1606
(410) 328-3100
(410) 328-8981
Mailing address
110 S PACA ST FL 3, BALTIMORE, MD 21201-1642
(443) 926-1293
(410) 328-8981
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R130529
MD
363LA2100X
Acute Care Nurse Practitioner
Primary
R130529
MD
363LC0200X
Critical Care Medicine Nurse Practitioner
R130529
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067423100
—
MD
01
—
S062-0536
CAREFIRST BC/BS
MD
Enumeration date
04/26/2012
Last updated
08/02/2024
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