Provider Demographics
NPI:1386945558
Name:BOHRMUELLER, KRISTINE ANN (ARNP)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:ANN
Last Name:BOHRMUELLER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1567
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61110-0067
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7527 W MINERAL POINT RD
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-8652
Practice Address - Country:US
Practice Address - Phone:888-708-0561
Practice Address - Fax:404-585-2688
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10508363L00000X
WAAP60191449363L00000X
NYF421572-01363L00000X
CO0003823363L00000X
IAF170074363L00000X
IL209-010404363L00000X
WI4550363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner