NPI 1659674182 · live from the CMS NPI Registry
Nicole Lynn Boucher, CPNP-PC
Nurse Practitioner, Pediatrics in Brighton, MI. National Provider Identifier 1659674182, active.
NPI record
| NPI | 1659674182 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 136 Kissane Ave, Suite A, Brighton, MI 48116 |
| Practice phone | 810-229-7337 |
| Enumerated | December 5, 2010 |
| Last updated | December 5, 2010 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 4704195198 (MI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.