Provider Demographics
NPI:1548670540
Name:BOKRAM, BARBARA
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:
Last Name:BOKRAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8650 SURFWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HARBOR SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49740-9151
Mailing Address - Country:US
Mailing Address - Phone:231-499-5213
Mailing Address - Fax:
Practice Address - Street 1:8650 SURFWOOD DR
Practice Address - Street 2:
Practice Address - City:HARBOR SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49740-9151
Practice Address - Country:US
Practice Address - Phone:231-499-5213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704072414163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult