Provider Demographics
NPI:1710376850
Name:BOECKMANN, NATALIE (APRN)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:BOECKMANN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22918
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72221-2918
Mailing Address - Country:US
Mailing Address - Phone:501-503-2610
Mailing Address - Fax:888-480-8550
Practice Address - Street 1:400 E COOK ST
Practice Address - Street 2:
Practice Address - City:FORREST CITY
Practice Address - State:AR
Practice Address - Zip Code:72335-2869
Practice Address - Country:US
Practice Address - Phone:501-503-2610
Practice Address - Fax:501-480-8550
Is Sole Proprietor?:No
Enumeration Date:2015-01-13
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR125705363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily