Provider Demographics
NPI:1144621327
Name:BOEHRINGER, JUSTINE LYNN (RN)
Entity Type:Individual
Prefix:
First Name:JUSTINE
Middle Name:LYNN
Last Name:BOEHRINGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JUSTINE
Other - Middle Name:LYNN
Other - Last Name:GROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1650 GARVEY AVE
Mailing Address - Street 2:
Mailing Address - City:ELSMERE
Mailing Address - State:KY
Mailing Address - Zip Code:41018-2541
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3200 VINE ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2213
Practice Address - Country:US
Practice Address - Phone:513-861-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN. 403140163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse