Provider Demographics
NPI:1245275494
Name:BOHLEN, KAREN ELLEN (FNP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ELLEN
Last Name:BOHLEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5642 GARROW GLEN RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-6984
Mailing Address - Country:US
Mailing Address - Phone:704-222-6298
Mailing Address - Fax:
Practice Address - Street 1:2605 WATER RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-4565
Practice Address - Country:US
Practice Address - Phone:704-306-9355
Practice Address - Fax:704-306-4614
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5001130363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily