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Contact Information

LISA J BOUCHER, P.A.-C
2 GREAT FALLS PLZ STE 21
AUBURN, ME04210-5966
 Phone: 207-330-3950
 Fax: 207-330-3955
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for LISA J BOUCHER · (Female)

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
  • CT License # 001342
  • ME License # PA646
  • NY License # 5606
  • NY Medicaid 02209570
Hospital affiliation(s)
  • ST MARYS REGIONAL MEDICAL CENTER - (Acute Care)
    CAMPUS AVENUE - PO BOX 291
    LEWISTON, ME 04240
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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