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

Mario Bouchard

Individual provider Critical Care Medicine Registered Nurse · NPI 1104350859

Mario Bouchard is a Critical Care Medicine Registered Nurse in Gallup, New Mexico. Licensed in Florida. Registered with an NPI since 2017.

Licensed in
FL
In the registry since
2017

Practice location Address checks out

516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone: (505) 722-1000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Critical Care Medicine Registered Nurse (primary) Taxonomy 163WC0200X · Licence RN 3173492 (FL)

Record details

NPI number1104350859
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 19, 2017
Last updated in NPPESApril 19, 2017
Mailing address516 E Nizhoni Blvd, Gallup, NM 87301-5748

Other providers in Gallup