Healthcare Provider Details

I. General information

NPI: 1750206967
Provider Name (Legal Business Name): ERIN BOOHER LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 W BROAD ST
COLUMBUS OH
43228-1672
US

IV. Provider business mailing address

812 HICKORY DR
MARYSVILLE OH
43040-1362
US

V. Phone/Fax

Practice location:
  • Phone: 614-544-1034
  • Fax:
Mailing address:
  • Phone: 937-269-6202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN.165033.MEDS-IV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: