Individual
MANDY JEAN BOECKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2796 W 500 S, PORTLAND, IN 47371-7308
(260) 729-3523
(812) 220-4280
Mailing address
2796 W 500 S, PORTLAND, IN 47371-7308
(260) 729-3523
(812) 220-4280
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71007881A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28209065A
—
IN
Enumeration date
03/07/2018
Last updated
04/08/2025
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