Individual
KIMBER ANNE BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2146 WALLINGFORD LOOP, MOUNT DORA, FL 32757-8503
(352) 423-0666
Mailing address
2146 WALLINGFORD LOOP, MOUNT DORA, FL 32757-8503
(352) 423-0666
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
178272
MA
363LG0600X
Gerontology Nurse Practitioner
178272
MA
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN11018226
FL
Other
Enumeration date
01/01/2007
Last updated
04/18/2022
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