Healthcare Provider Details

I. General information

NPI: 1952234098
Provider Name (Legal Business Name): MARIANNE BOHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9157 E 36TH ST
NEWAYGO MI
49337-8212
US

IV. Provider business mailing address

9157 E 36TH ST
NEWAYGO MI
49337-8212
US

V. Phone/Fax

Practice location:
  • Phone: 844-670-2273
  • Fax: 833-626-1944
Mailing address:
  • Phone: 844-670-2273
  • Fax: 833-626-1944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: