Provider Demographics
NPI:1376261867
Name:BOEGEL, KARLY K (APNP)
Entity Type:Individual
Prefix:
First Name:KARLY
Middle Name:K
Last Name:BOEGEL
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:SSM HEALTH FDL REGIONAL CLINIC
Mailing Address - Street 2:1808 W BELTLINE HWY
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-2334
Mailing Address - Country:US
Mailing Address - Phone:920-926-8343
Mailing Address - Fax:
Practice Address - Street 1:723 PARK RIDGE LN
Practice Address - Street 2:
Practice Address - City:N FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54937-1385
Practice Address - Country:US
Practice Address - Phone:920-926-8600
Practice Address - Fax:920-926-8650
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI1308133363L00000X
WI13081-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner