| Doctor Name: | MRS. REBECCA S BOEHME |
| NPI Number: | 1477636058 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN FNP |
| License Number: | NP3799 |
| Business Practice Address: | 725 Pine St Mount Shasta, CA - 960672133 |
| Business Phone Number: | 5309264556 |
| Business Fax Number: | 5309264532 |
| Mailing Address: | 725 Pine St, MOUNT SHASTA |
| State: | CA |
| Postal Code: | 960672133 |
| Phone Number: | 5309264556 |
| Fax Number: | 5309264532 |
| NPI Enumeration Date: | 10/24/2006 |
| NPI Last Update Date: | 02/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | NP3799 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |