Provider Demographics
NPI:1144965393
Name:BOHENSTENGEL, EMILY LOUISE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:LOUISE
Last Name:BOHENSTENGEL
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 GREENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROTHSCHILD
Mailing Address - State:WI
Mailing Address - Zip Code:54474-1138
Mailing Address - Country:US
Mailing Address - Phone:715-315-2068
Mailing Address - Fax:
Practice Address - Street 1:213 GREENWOOD DR
Practice Address - Street 2:
Practice Address - City:ROTHSCHILD
Practice Address - State:WI
Practice Address - Zip Code:54474-1138
Practice Address - Country:US
Practice Address - Phone:715-315-2068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI251537163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse