Provider Demographics
NPI:1831531797
Name:BOHNERT, DONNA MARIE (FNP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
Last Name:BOHNERT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KNIGHTSTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46148-1260
Mailing Address - Country:US
Mailing Address - Phone:765-345-5572
Mailing Address - Fax:765-445-1004
Practice Address - Street 1:224 W MAIN ST
Practice Address - Street 2:
Practice Address - City:KNIGHTSTOWN
Practice Address - State:IN
Practice Address - Zip Code:46148-1260
Practice Address - Country:US
Practice Address - Phone:765-345-5572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-20
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004496A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily