Individual
JILL M BOUCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANPC
Contact information
Practice address
242 BRUNSWICK ST, OLD TOWN, ME 04468-1613
(207) 827-6128
(207) 827-6605
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 404-8200
(207) 947-0435
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
CNP211360
ME
Other
Enumeration date
07/08/2015
Last updated
01/12/2024
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