| Doctor Name: | KATHEY DIANNE BOECKMANN |
| NPI Number: | 1346284841 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | A.P.N. |
| License Number: | A01022 |
| Business Practice Address: | 704 Canal Ave E Wynne, AR - 723963042 |
| Business Phone Number: | 8702392101 |
| Business Fax Number: | 8702384569 |
| Mailing Address: | 21 County Road 628, WYNNE |
| State: | AR |
| Postal Code: | 723968424 |
| Phone Number: | 8705885256 |
| Fax Number: | 8702384569 |
| NPI Enumeration Date: | 06/15/2006 |
| NPI Last Update Date: | 09/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | A01022 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |