Provider Demographics
NPI:1336976414
Name:BOHMIER, MONSERRAT ALEXIS (FNP)
Entity type:Individual
Prefix:
First Name:MONSERRAT
Middle Name:ALEXIS
Last Name:BOHMIER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MONSERRAT
Other - Middle Name:ALEXIS
Other - Last Name:MIRANDA MIRANDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:797 E SPRUCE MESA WAY
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-5508
Mailing Address - Country:US
Mailing Address - Phone:517-292-9318
Mailing Address - Fax:
Practice Address - Street 1:3920 S 1100 E STE 150
Practice Address - Street 2:
Practice Address - City:MILLCREEK
Practice Address - State:UT
Practice Address - Zip Code:84124-1266
Practice Address - Country:US
Practice Address - Phone:801-230-0586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13145007-8900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily