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NPI Code Detail

MEDICARE: VERONICA L BOOCHER RN

MEDICARE: VERONICA L BOOCHER RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WA0400XAddiction (Substance Use Disorder) Registered Nurse474632OH
2171M00000XCase Manager/Care CoordinatorRBT-22-207802OH

General Provider Information

NPI Number : 1013504406
Entity Type Code : Individual
Provider Name (Legal Business Name) : VERONICA L BOOCHER RN
Provider Business Mailing Address
First Line : 445 E DUBLIN GRANVILLE RD
Second Line :
City : WORTHINGTON
State : OH
Zip : 43085-3192
Country : US
Telephone Number : 614-844-3800
Fax Number :
Provider Business Practice Location Address
First Line : 700 LIBERTY LN
Second Line :
City : DAYTON
State : OH
Zip : 45449-2135
Country : US
Telephone Number : 937-247-2400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2020
Last Update Date : 05/23/2022

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