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General NPI Number Information
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NPI Number | 1003884685
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Entity Type | Individual
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Provider Name | BONNIE BOUCHARD CNM
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Gender | Female
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 2300 SOUTHWOOD DR
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City | NASHUA
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State | NH
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Zip | 03063-1818
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Country | US
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Telephone | 603-577-4000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 40
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City | CARIBOU
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State | ME
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Zip | 04736-0040
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Country | US
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Telephone | 207-498-2359
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Fax | 207-498-3947
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN27700
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | CNM82022
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 090915-23
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License Number State | NH
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