Boettcher, Mildred D.

Boettcher, Mildred D. is an individual health care provider with primary practice located at 34Th And Civic Center Blvd , Philadelphia PA 19104. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Boettcher, Mildred D. can be contacted via phone (215) 590-3630.

Contact Information

Primary practice address
34Th And Civic Center Blvd Philadelphia PA 19104
Phone: (215) 590-3630
Fax: (215) 590-3606
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X TP004267N Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X TP004267N Pennsylvania

Profile Details

NPI number 1245321538
LBN Legal business name Boettcher, Mildred D.
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2006
Last updated Aug 7th, 2008 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245321538 NPPES
New Jersey MEDICAID 8668809

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