MEDICARE: MEGHAN ELIZABETH BOHNENKAMP APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	4056169	KY

General Provider Information

NPI Number	:	1730015033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN ELIZABETH BOHNENKAMP APRN

Provider Business Mailing Address
First Line	:	3914 MEADOWFIELD DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40245-5404
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3914 MEADOWFIELD DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40245-5404
Country	:	US
Telephone Number	:	502-322-2705
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2026
Last Update Date	:	06/23/2026

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