Healthcare Provider Details

I. General information

NPI: 1730744533
Provider Name (Legal Business Name): ASHLEY MARIE BOEHRIG MSN, WHNP-BC, APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY MARIE BETH RN

II. Dates (important events)

Enumeration Date: 05/07/2019
Last Update Date: 05/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-8570
  • Fax:
Mailing address:
  • Phone: 414-805-8570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number9246-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: