Individual
MRS. DARCIE ELLEN BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 N RAINBOW BLVD, SUITE 203, LAS VEGAS, NV 89107
(702) 259-1228
(702) 433-2477
Mailing address
500 N RAINBOW BLVD SUITE 203, LAS VEGAS, NV 89107
(702) 259-1228
(702) 433-2477
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
153222
OR
363A00000X
Physician Assistant
Primary
PA1312
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500629170
DMAP/DEPARTMENT OF HUMAN SERVICES
OR
01
—
69568060
BLUE CROSS BLUE SHIELD
OR
Enumeration date
10/18/2010
Last updated
05/19/2023
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