Michelle Boucher, RD

Individual provider Active NPI Registered Dietitian · Bow, NH

NPI 1366023657 · NPPES record last updated Apr 19, 2021

Key facts

NPI
1366023657
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
1167 (NH)
Practice address
39 Brown Hill Rd
Bow, NH 03304-4805
Phone
(603) 913-5048
NPI assigned
Apr 19, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1167 NH Yes

Addresses

Primary practice location

39 Brown Hill Rd
Bow, NH 03304-4805

Mailing address

195 McGregor St Apt 116
Manchester, NH 03102-3834
Phone (603) 913-5048

Other practice location 1

195 McGregor St Apt 116
Manchester, NH 03102-3834
Phone (603) 913-5048

Other identifiers

IdentifierTypeStateIssuer
1167OtherNHNH BOARD OF LICENSED DIETITIANS

Other providers in Bow, NH

All providers in Bow, NH · Registered Dietitian in New Hampshire

Sources for this page

Verify at the official NPI Registry.