Provider Demographics
NPI:1508995531
Name:BOHRER, MELODY SUE (RN,BSN,BC,PCCN)
Entity Type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:SUE
Last Name:BOHRER
Suffix:
Gender:F
Credentials:RN,BSN,BC,PCCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7937 YORKRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47022-9668
Mailing Address - Country:US
Mailing Address - Phone:812-487-2232
Mailing Address - Fax:
Practice Address - Street 1:7937 YORKRIDGE RD
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:IN
Practice Address - Zip Code:47022-9668
Practice Address - Country:US
Practice Address - Phone:812-487-2232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-126555163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health