Individual
GINGER BOHN RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
7137 236TH AVE, SALEM, WI 53168-8975
(262) 846-4422
Mailing address
7137 236TH AVE, SALEM, WI 53168-8975
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9363-33
WI
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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