Healthcare Provider Details

I. General information

NPI: 1295665909
Provider Name (Legal Business Name): MISS ELIZABETH ANN BOEHMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS LIBBY ANN BOEHMER

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 AUBURN AVE FL 3
CINCINNATI OH
45219-2906
US

IV. Provider business mailing address

302 NEWPINE DR
CLEVES OH
45002-2385
US

V. Phone/Fax

Practice location:
  • Phone: 513-572-8720
  • Fax:
Mailing address:
  • Phone: 513-309-4959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number603143290126
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: