Doctor Name: | MIRIAH BOOCHER |
NPI Number: | 1134167265 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS,APRN,BC |
License Number: | NP-08436 |
Business Practice Address: | 5772 S State Route 721 Laura, OH - 453379717 |
Business Phone Number: | 9378848725 |
Business Fax Number: | |
Mailing Address: | 5772 S State Route 721, LAURA |
State: | OH |
Postal Code: | 453379717 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/02/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | NP-08436 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |