Provider Demographics
NPI:1669919577
Name:BOHN, NATALIE RAE (PA-C)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:RAE
Last Name:BOHN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N RAINBOW BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-1084
Mailing Address - Country:US
Mailing Address - Phone:702-259-1228
Mailing Address - Fax:
Practice Address - Street 1:500 N RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-1082
Practice Address - Country:US
Practice Address - Phone:702-259-1228
Practice Address - Fax:866-460-6277
Is Sole Proprietor?:No
Enumeration Date:2017-01-30
Last Update Date:2025-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV363A00000X
OH50.004921RX363A00000X
NVPA0367363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant