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NPI Code Detail

MEDICARE: AMIE LYNN BOELKE RN, BSN

MEDICARE: AMIE LYNN BOELKE RN, BSN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse201122ND

General Provider Information

NPI Number : 1467335059
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMIE LYNN BOELKE RN, BSN
Provider Business Mailing Address
First Line : 901 8TH AVE S APT 205
Second Line :
City : WAHPETON
State : ND
Zip : 58075-4852
Country : US
Telephone Number : 734-837-9141
Fax Number :
Provider Business Practice Location Address
First Line : 2101 ELM ST N
Second Line :
City : FARGO
State : ND
Zip : 58102-2417
Country : US
Telephone Number : 701-232-3241
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2025
Last Update Date : 04/13/2026

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