MEDICARE: BRANDI RENEE BOEHME

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1801452602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI RENEE BOEHME

Provider Business Mailing Address
First Line	:	2855 GEER RD
Second Line	:
City	:	TURLOCK
State	:	CA
Zip	:	95382-1133
Country	:	US
Telephone Number	:	209-668-9361
Fax Number	:

Provider Business Practice Location Address
First Line	:	1195 E TUOLUMNE RD
Second Line	:
City	:	TURLOCK
State	:	CA
Zip	:	95382-1541
Country	:	US
Telephone Number	:	209-632-9600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2019
Last Update Date	:	05/16/2019

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Directions to “ BRANDI RENEE BOEHME ” Practice Location

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