Provider Demographics
NPI:1538166541
Name:BOHEN, CYNTHIA (APRN)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:BOHEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 CCC TRL
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-9609
Mailing Address - Country:US
Mailing Address - Phone:606-784-3519
Mailing Address - Fax:
Practice Address - Street 1:425 N MAYSVILLE ST
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-1050
Practice Address - Country:US
Practice Address - Phone:606-783-6805
Practice Address - Fax:606-783-6869
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3002096363LP0808X, 363L00000X
KY2096-S364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000341735OtherANTHEM BC/BS
KY000000353507OtherANTHEM BLUE CROSS AND BLU
KY30610026Medicaid
KY78013612Medicaid
KY0944801Medicare ID - Type UnspecifiedINDIVIDUAL
KY78013612Medicaid
KYK134281 SC COUNSEMedicare PIN
KY1169221OtherCHA HEALTH