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NICOLE SUZANNE BOERSMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
718 N LINCOLN ST, GREENSBURG, IN 47240-1348
(812) 662-0588
(812) 663-1155
Mailing address
718 N LINCOLN ST, GREENSBURG, IN 47240-1348
(812) 662-0588
(812) 663-1155

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
01062609A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200889340
IN
01
P01447581
RAILROAD MEDICARE
IN
Enumeration date
04/18/2007
Last updated
03/07/2016
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