Individual provider · Type 1 NPI
Mario Bouchard
Critical Care Medicine Registered Nurse · Gallup, NM
NPI number
1104350859
Active
Practice location
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Critical Care Medicine Registered Nurse Primary | 163WC0200X | RN 3173492 (FL) |
Critical Care Medicine Registered Nurse: Definition to come...
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About NPI 1104350859
Mario Bouchard's National Provider Identifier is 1104350859, issued on Apr 19, 2017. The primary taxonomy on file is Critical Care Medicine Registered Nurse (163WC0200X), and the practice location is in Gallup, NM. The record was last updated on Apr 19, 2017.