Stacey Marie Boucher, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95009319 Issued in CA

Practice address

4200 Regent St Ste 200
Columbus, OH 43219-6229

Phone

(877) 870-1775

Fax

(614) 968-8840

NPI assigned

Sep 11, 2018

Last updated

Sep 25, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1659854230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 REGENT ST STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432196229",
            "telephone_number": "877-870-1775",
            "fax_number": "614-968-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 REGENT ST STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432196229",
            "telephone_number": "877-870-1775",
            "fax_number": "614-968-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "STACEY",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khaled Boubes, M.D.
• Soumya Bouchachi, M.D.
• Traci Ann Bouchard, MD
• Erick Matthew Boucher, ATC
• Laura Carol Boucher, ATC
• Stephanie Boucher, LPN
• Lauren Louise Boucherle, PA-C
• Konstantinos D Boudoulas, M.D.
• Michelle Leigh Boudoulas, CRNA
• Olga Boudoulas, MD

• Family Nurse Practitioner in Columbus, OH
• Providers in Columbus, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.