Provider Demographics
NPI:1972798288
Name:BOHATY, KAREN R (APRN)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:R
Last Name:BOHATY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:R
Other - Last Name:KUNZE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX M
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NE
Mailing Address - Zip Code:68446-0517
Mailing Address - Country:US
Mailing Address - Phone:402-269-2011
Mailing Address - Fax:402-269-2795
Practice Address - Street 1:204 N RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:WEEPING WATER
Practice Address - State:NE
Practice Address - Zip Code:68463-4253
Practice Address - Country:US
Practice Address - Phone:402-267-5330
Practice Address - Fax:402-267-5331
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110891363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE254730OtherMIDLANDS CHOICE
KS200533560AMedicaid
NE39291OtherBCBS
NE39291OtherBCBS