Provider Demographics
NPI:1922675289
Name:BOEHM, LINDSAY MICHELLE (APRN)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MICHELLE
Last Name:BOEHM
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 1:1285 FRANCISCAN DR
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62056-1778
Mailing Address - Country:US
Mailing Address - Phone:217-324-1005
Mailing Address - Fax:217-324-6411
Practice Address - Street 1:1285 FRANCISCAN DR
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:IL
Practice Address - Zip Code:62056-1778
Practice Address - Country:US
Practice Address - Phone:217-324-1005
Practice Address - Fax:217-324-6411
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209021320363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily