Provider Demographics
NPI:1356052617
Name:BOCHNIAK, PETER LUKE II (FNP-BC)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:LUKE
Last Name:BOCHNIAK
Suffix:II
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 CREEKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-7904
Mailing Address - Country:US
Mailing Address - Phone:219-707-9989
Mailing Address - Fax:
Practice Address - Street 1:3903 E LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5810
Practice Address - Country:US
Practice Address - Phone:219-736-0900
Practice Address - Fax:219-769-5803
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71013293A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily