Individual
KALEY BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
13695 US HIGHWAY 1, SEBASTIAN, FL 32958-3230
(716) 603-8140
Mailing address
13695 US HIGHWAY 1, SEBASTIAN, FL 32958-3230
(716) 603-8140
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9409424
FL
367500000X
Certified Registered Nurse Anesthetist
129794
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11005436
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105303700
—
FL
Enumeration date
09/11/2019
Last updated
04/01/2025
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