MS. LISA MARIE BOUCHER PA-C
NPI 1679709463
Physician Assistant in Wyandotte, MI

Active since June 07, 2009
2333 BIDDLE AVE, WYANDOTTE, MI 48192(734) 246-6000 Get Directions Write a Review

NPPES record last updated: February 21, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Lisa Marie Boucher Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. LISA MARIE BOUCHER PA-C (NPI 1679709463) is an individual physician assistant in Wyandotte, Michigan, licensed in Michigan (5601005490) and active in the NPI registry since June 2009.

NPPES Registry Identity

NPI1679709463
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMS. LISA MARIE BOUCHERCredential: PA-C
Location Address2333 BIDDLE AVEWyandotte, MI 48192-4668
Mailing Address1640 Fort St, Suite D Attne DeniseTrenton, MI 48183-2040 · (734) 391-3057 · Fax (734) 391-3052
Sole ProprietorNo
Enumeration DateJune 7, 2009
Last NPPES UpdateFebruary 21, 2017
NPI 1679709463 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in MI · 5601005490
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
2333 BIDDLE AVE, Wyandotte, MI 48192

Other Identifiers 2

Medicare PINQ24657055MI
Other0H28864MI · Blue Cross

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Podiatrist (Foot & Ankle Surgery)
2333 BIDDLE AVE
WYANDOTTE, MI 48192
Emergency Medicine
2333 BIDDLE AVE
WYANDOTTE, MI 48192
Emergency Medicine
2333 BIDDLE AVE
WYANDOTTE, MI 48192
Obstetrics & Gynecology
2333 BIDDLE AVE
WYANDOTTE, MI 48192
Internal Medicine
2333 BIDDLE AVE
WYANDOTTE, MI 48192
Surgery
2333 BIDDLE AVE
WYANDOTTE, MI 48192
Obstetrics & Gynecology
2333 BIDDLE AVE
WYANDOTTE, MI 48192
Student in an Organized Health Care Education/Training Program
2333 BIDDLE AVE
WYANDOTTE, MI 48192

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Boucher's NPI number?

The NPI number for Lisa Boucher is 1679709463. It was assigned to this individual provider in the NPPES registry on June 7, 2009.

Where is Lisa Boucher located?

Lisa Boucher practices at 2333 Biddle Ave, Wyandotte, MI 48192. The listed phone number is (734) 246-6000.

What is Lisa Boucher's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Lisa Boucher was last updated on February 21, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.