Provider Demographics
NPI:1861749921
Name:BOEHM, ABIGAIL E (CNM, MSN)
Entity type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:E
Last Name:BOEHM
Suffix:
Gender:F
Credentials:CNM, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08608-1501
Mailing Address - Country:US
Mailing Address - Phone:609-599-4881
Mailing Address - Fax:609-989-4846
Practice Address - Street 1:2000 PENNINGTON RD
Practice Address - Street 2:EICKHOFF HALL - ROOM 140
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-1104
Practice Address - Country:US
Practice Address - Phone:609-771-2110
Practice Address - Fax:609-637-5131
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00027700367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife