Individual
SHIRLEY BOUCHET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
111 PARK AVE, BALTIMORE, MD 21201-3402
(410) 837-5533
Mailing address
1413 TARRAGON CT, BELCAMP, MD 21017-1381
(410) 837-5533
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R095397
MD
163WC1500X
Community Health Registered Nurse
Primary
R095397
MD
Other
Enumeration date
05/20/2007
Last updated
01/20/2010
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