Individual
STACEY BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-C
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
101.0093987
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101.0093987
STATE OF VT APRN LICENSE
VT
Enumeration date
03/12/2013
Last updated
10/23/2023
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