Individual
JANET S BOECKMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5886
(260) 484-8551
(260) 482-5060
Mailing address
5052 N CLINTON ST, FORT WAYNE, IN 46825-5822
(260) 484-8551
(260) 482-5060
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28083037A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200279250
—
IN
01
—
430043625
RAIL ROAD MEDICARE
IN
Enumeration date
08/09/2005
Last updated
10/24/2018
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