Healthcare Provider Details

I. General information

NPI: 1407645385
Provider Name (Legal Business Name): KAYLA NICOLE BOEHNER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10191 EVENDALE COMMONS DR
CINCINNATI OH
45241-2689
US

IV. Provider business mailing address

3392 STATE ROUTE 725 W
CAMDEN OH
45311-9652
US

V. Phone/Fax

Practice location:
  • Phone: 513-817-1150
  • Fax:
Mailing address:
  • Phone: 513-910-3303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRNCRNA0021379
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: