Individual
LAURA MAE BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
50 SUMMER ST, MILLINOCKET, ME 04462-1400
(366) 866-5842
Mailing address
95 CANYON DR, MILLINOCKET, ME 04462-2328
(297) 731-4419
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN68788
ME
Other
Enumeration date
08/07/2019
Last updated
09/01/2020
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