Individual
RENEE M BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3 MEMORIAL DR, WINCHENDON, MA 01475-1279
(978) 297-5052
(978) 297-5430
Mailing address
242 GREEN ST, GARDNER, MA 01440-1336
(978) 630-5076
(978) 630-5078
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
230888
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0714267
—
MA
Enumeration date
12/08/2005
Last updated
01/21/2010
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