Provider Demographics
NPI:1699375469
Name:BOUCHARD, CLAIRE CATHERINE (DNP, AGACNP-BC)
Entity Type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:CATHERINE
Last Name:BOUCHARD
Suffix:
Gender:F
Credentials:DNP, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 PATRICIA CT
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-2647
Mailing Address - Country:US
Mailing Address - Phone:520-979-2306
Mailing Address - Fax:
Practice Address - Street 1:2606 PATRICIA CT
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-2647
Practice Address - Country:US
Practice Address - Phone:520-979-2306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ195150163WE0003X
MI4704371449363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WE0003XNursing Service ProvidersRegistered NurseEmergency