Individual
MRS. BEVERLEY L BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPM, LM
Contact information
Practice address
1003 MAHONE ST, FREDERICKSBURG, VA 22401-6214
(540) 318-0055
Mailing address
6800 HANOVER CT, FREDERICKSBURG, VA 22407-6209
(540) 688-9100
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
CPM22050016
VA
176B00000X
Midwife
PENDING
VA
374J00000X
Doula
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0129000176
VIRGINIA DEPARTMENT OF HEALTH PROFESSIONALS
VA
01
—
99499
CPT
VA
Enumeration date
05/20/2014
Last updated
10/31/2022
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