Individual
JAMIE R BOHNKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1614 25TH ST, BEDFORD, IN 47421-5000
(812) 277-0118
(812) 277-0127
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
71004476A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201167860
—
IN
Enumeration date
06/17/2013
Last updated
04/10/2025
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