Kyle Boucher
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Portland, ME
NPI 1831007806 · NPPES record last updated Aug 31, 2026
Key facts
- NPI
- 1831007806
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 716 Stevens Ave
Portland, ME 04103-2693 - Phone
- (207) 221-4516
- NPI assigned
- Aug 31, 2026
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
716 Stevens Ave
Portland, ME 04103-2693
Mailing address
716 Stevens Ave
Portland, ME 04103-2693
Phone (207) 221-4516
Other providers in Portland, ME
- Timothy Noel Botler
- Graham Michael Botto
- Hannah Janae Bouchard
- Benjamin Boucher
- Bradley Boucher
- Nathan Boucher
- Anna Sophia Bouck
- Lillian Boudreau
- Mathieu Nadim Boulad
- Nancy R Boulanger
All providers in Portland, ME · Student in an Organized Health Care Education/Training Program in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.