Individual
STACEY BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-C
Contact information
Practice address
12 CREST RD, SAINT ALBANS, VT 05478-9701
(802) 524-4554
(802) 527-6792
Mailing address
44 MAIN ST, STE 200, RICHFORD, VT 05476-1141
(802) 255-5541
(802) 524-7021
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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