| Doctor Name: | WENDY J BOUCHER |
| NPI Number: | 1811962988 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 22383 |
| Business Practice Address: | 1001 Noble St Fairbanks, AK - 997014922 |
| Business Phone Number: | 9074593500 |
| Business Fax Number: | 9074582653 |
| Mailing Address: | 1001 Noble St, FAIRBANKS |
| State: | AK |
| Postal Code: | 997014922 |
| Phone Number: | 9074593500 |
| Fax Number: | 9074582653 |
| NPI Enumeration Date: | 02/21/2006 |
| NPI Last Update Date: | 01/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 22383 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NE |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |