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General NPI Number Information
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NPI Number | 1679931778
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Entity Type | Individual
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Provider Name | CONNIE RENEE BOEHMAN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/03/2016
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 610 E WALNUT ST STE A
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City | EVANSVILLE
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State | IN
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Zip | 47713-2460
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Country | US
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Telephone | 844-999-9019
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Fax |
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Provider Business Mailing Address
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Address Line | 3923 CROSS CREEK TRL
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City | OWENSBORO
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State | KY
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Zip | 42303-1895
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Country | US
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Telephone | 812-719-9414
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3010041
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71006571A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201318
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License Number State | ND
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