Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mallory Jannelle Boucher, NP

Individual provider Nurse Practitioner · NPI 1336945161

Mallory Jannelle Boucher, NP is a Nurse Practitioner in Rochester, Minnesota. Qualified in 2025, 1 year ago. Practices with Mayo Clinic, a 4,796-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
1
Licensed in
MN
In the registry since
2025
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

200 1st St SW
Rochester, MN 55905-0001
Phone: (507) 284-2511
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 12869 (MN)

Record details

NPI number1336945161
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedFebruary 21, 2025
Last updated in NPPESJune 25, 2025
Certification dateJune 25, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Mayo Clinic — 4796 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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