Boucher, Jennifer S

Boucher, Jennifer S is an individual health care provider with primary practice located at 19020 Fort St , Riverview MI 48193-6701. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Boucher, Jennifer S can be contacted via phone (734) 362-5100.

Contact Information

Primary practice address
19020 Fort St Riverview MI 48193-6701
Phone: (734) 362-5100
Fax: (734) 362-5147
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4704180289 Michigan

Profile Details

NPI number 1861583494
LBN Legal business name Boucher, Jennifer S
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861583494 NPPES
Michigan Other 4704180289 NP SPECIALTY BOARD CERT

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