Individual
RANDI NICOLE BOUCHILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C
Contact information
Practice address
85 HOSPITAL RD, PRINCE FREDERICK, MD 20678-4018
(410) 535-2300
Mailing address
23120 POND POINT FARM LN, CHAPTICO, MD 20621-2424
(240) 717-9661
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
R244896
MD
363LF0000X
Family Nurse Practitioner
Primary
R244896
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
815444357
—
MD
01
—
R244896
RN
MD
Enumeration date
06/08/2022
Last updated
05/15/2026
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