Individual
KRISTI MICHELLE BOHLIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1990 CONNECTICUT AVE S STE 100, SARTELL, MN 56377-2554
(202) 575-5953
(320) 257-5596
Mailing address
1990 CONNECTICUT AVE S STE 100, SARTELL, MN 56377-2554
(202) 575-5953
(320) 257-5596
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
923
ND
363A00000X
Physician Assistant
Primary
13049
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13049
MN LICENSE
MN
01
—
923
ND LICENSURE
ND
Enumeration date
02/01/2013
Last updated
08/02/2019
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