NPI Profile for LISA J BOUCHER in AUBURN, ME.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical |
363AM0700X | 97 | Physician Assistant | |
Physician Assistant |
363A00000X | 97 | Physician Assistant |
| NPI Number | 1730285982 |
|
| Status | Active | |
| Credentials | P.A.-C | |
| Entity | Individual | |
| Enumeration date | 09/15/2006 | |
| Last updated | 11/08/2022 - About 4 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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| Hospital affiliation(s) |
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LISA J BOUCHER
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