Healthcare Provider Details

I. General information

NPI: 1144318429
Provider Name (Legal Business Name): KAREN K BOHN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 11/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9333 N. MERIDIAN ST SUITE 202
INDIANAPOLIS IN
46260-1821
US

IV. Provider business mailing address

9333 N. MERIDIAN ST SUITE 202
INDIANAPOLIS IN
46260-1821
US

V. Phone/Fax

Practice location:
  • Phone: 317-580-9333
  • Fax: 317-577-7433
Mailing address:
  • Phone: 317-580-9333
  • Fax: 317-577-7433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number71000621A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: