Individual
DAISY A BOEHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
3925 N GATEWAY DR, APPLETON, WI 54913-7863
(920) 749-1171
Mailing address
3232 N BALLARD RD, APPLETON, WI 54911-8804
(920) 749-9668
(920) 734-5307
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3137
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194925479
—
WI
Enumeration date
07/24/2007
Last updated
06/22/2016
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