Boucher, Lisa Jean

Boucher, Lisa Jean is an sole proprietor health care provider with primary practice located at 2 Great Falls Plz Ste 21 , Auburn ME 04210-5966. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Boucher, Lisa Jean can be contacted via phone (207) 330-3950.

Contact Information

Primary practice address
2 Great Falls Plz Ste 21 Auburn ME 04210-5966
Phone: (207) 330-3950
Fax: (207) 330-3955
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5606 New York
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA646 Maine
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 001342 Connecticut

Profile Details

NPI number 1730285982
LBN Legal business name Boucher, Lisa Jean
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 15th, 2006
Last updated Nov 8th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730285982 NPPES
New York MEDICAID 02209570

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