Provider Demographics
NPI:1629501093
Name:BOOHER, BRIDGET (APN)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:BOOHER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:
Other - Last Name:CAREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1307 S FILLMORE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-2501
Mailing Address - Country:US
Mailing Address - Phone:815-482-9894
Mailing Address - Fax:
Practice Address - Street 1:8190 E 1ST AVE STE 100
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7211
Practice Address - Country:US
Practice Address - Phone:720-859-8222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN. 0993026363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics