Healthcare Provider Details

I. General information

NPI: 1003731860
Provider Name (Legal Business Name): BOHL MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5030 PARADISE RD STE C114
LAS VEGAS NV
89119-1232
US

IV. Provider business mailing address

5030 PARADISE RD STE C114
LAS VEGAS NV
89119-1232
US

V. Phone/Fax

Practice location:
  • Phone: 725-260-6844
  • Fax:
Mailing address:
  • Phone: 725-260-6844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. CATHERINE D BOHL
Title or Position: ADMINISTRATOR
Credential: MSN, APRN-CNP, FNP-C
Phone: 725-260-6844