Individual
REGINA MARIE BOUGHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4160 TUDOR CENTRE DR, ANCHORAGE, AK 99508-5901
(907) 729-8624
Mailing address
4201 TUDOR CENTRE DR, SUITE 320, ANCHORAGE, AK 99508-5904
(907) 729-8624
(907) 729-8607
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6327
AK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMO210
—
AK
Enumeration date
03/29/2011
Last updated
12/18/2012
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