| Doctor Name: | ANGELA DENISE BOEHNEN |
| NPI Number: | 1639576994 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 95001912 |
| Business Practice Address: | 112 Helen St Sauk City, WI - 535831101 |
| Business Phone Number: | 6086433351 |
| Business Fax Number: | |
| Mailing Address: | 112 Helen St, SAUK CITY |
| State: | WI |
| Postal Code: | 535831101 |
| Phone Number: | 6086433351 |
| Fax Number: | |
| NPI Enumeration Date: | 12/01/2014 |
| NPI Last Update Date: | 09/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 95001912 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |