Individual
BENJAMIN BOERNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6565 PERIMETER DR, DUBLIN, OH 43016-8461
(740) 304-0151
Mailing address
410 W 10TH AVE, COLUMBUS, OH 43210-1240
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
409226
OH
363LF0000X
Family Nurse Practitioner
Primary
0027182
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRNCNP0027182
LICENSE
OH
Enumeration date
06/30/2020
Last updated
09/23/2020
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