Healthcare Provider Details

I. General information

NPI: 1366403222
Provider Name (Legal Business Name): JANE KRISTINE BOHNENKAMP MA CCCA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: JANE KRISTINE CRABTREE MA CCA

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

834 W 4 STREET
WATERLOO IA
50702
US

IV. Provider business mailing address

536 BAKER DRIVE
CEDAR FALLS IA
50613
US

V. Phone/Fax

Practice location:
  • Phone: 319-230-4360
  • Fax:
Mailing address:
  • Phone: 319-277-3905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number00587
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number00872
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: