Individual provider Active NPI

Jenny P Boucicaut

  • Psychiatric/Mental Health Nurse Practitioner
  • Miramar, FL
National Provider Identifier
1578429189
Registry record updated Dec 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11044062 Issued in FL
Practice address
16297 SW 20TH St
Miramar, FL 33027-4461
Phone
(954) 991-9292
NPI assigned
Dec 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11044062 FL Primary

Addresses

Primary practice location

16297 SW 20TH St
Miramar, FL 33027-4461

Mailing address

16297 SW 20TH St
Miramar, FL 33027-4461
Phone (954) 991-9292

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11044062FLMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1766793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766793600000",
    "number": "1578429189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16297 SW 20TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274461",
            "telephone_number": "954-991-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16297 SW 20TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274461",
            "telephone_number": "954-991-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCICAUT",
        "first_name": "JENNY P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-27",
        "last_updated": "2025-12-27",
        "certification_date": "2025-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11044062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.