Boehm, Daisy A
Boehm, Daisy A is an individual health care provider with primary practice located at 3925 N Gateway Dr , Appleton WI 54913-7863. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Boehm, Daisy A can be contacted via phone (920) 749-1171.Contact Information
Primary practice address
3925 N Gateway Dr
Appleton WI 54913-7863
Phone: (920) 749-1171
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 3137 | Wisconsin |
Profile Details
| NPI number | 1194925479 |
|---|---|
| LBN Legal business name | Boehm, Daisy A |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 24th, 2007 |
| Last updated | Jun 22nd, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194925479 | NPPES |
| Wisconsin | MEDICAID | 1194925479 |
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