Boucher, Nan M

Boucher, Nan M is an individual health care provider with primary practice located at 99 Campus Ave Suite 201, Lewiston ME 04240-6045. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Boucher, Nan M can be contacted via phone (207) 777-8810.

Contact Information

Primary practice address
99 Campus Ave Suite 201 Lewiston ME 04240-6045
Phone: (207) 777-8810
Fax: (207) 777-8155
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X AP081044 Maine
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X CNP81044 Maine

Profile Details

NPI number 1033157227
LBN Legal business name Boucher, Nan M
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated Nov 8th, 2022 - about 4 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 1033157227 NPPES
New Hampshire MEDICAID 30347091
New Hampshire MEDICAID 432184299

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