| Doctor Name: | GENEI S BOUGHER |
| NPI Number: | 1063414092 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | RN 2565762 |
| Business Practice Address: | 400 Gulf Breeze Pkwy Suite 300 Gulf Breeze, FL - 325614495 |
| Business Phone Number: | 8509325055 |
| Business Fax Number: | 8509321404 |
| Mailing Address: | 400 Gulf Breeze Pkwy, Suite 300 GULF BREEZE |
| State: | FL |
| Postal Code: | 325614495 |
| Phone Number: | 8509325055 |
| Fax Number: | 8509321404 |
| NPI Enumeration Date: | 08/10/2005 |
| NPI Last Update Date: | 12/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | RN 2565762 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |