DR. KELLEEN BOEHLKE (NPI# 1396249652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396249652 |
| Entity Type | Individual |
| Full Name | DR. KELLEEN BOEHLKE |
| Credential | MD |
| Practice Address |
601 5th St S St Petersburg FL 33701-4804 |
| Mailing Address |
2355 University Ave Apt 202 Madison WI 53726-3829 |
| Practice Telephone | 7277674106 |
| Practice Fax Number | 7277678804 |
| Mailing Telephone | 9202879988 |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2018-03-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | FL | Student, Health Care |
| Street Address |
601 5TH ST S |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33701-4804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760485890 | Gregory A Hale | Pediatrics | 601 5th St S, 3rd Floor, St Petersburg, FL 33701-4804 | 2005-05-23 |
| 1932733656 | Lauren Stark Gray | Nurse Practitioner | 601 5th St S, St Petersburg, FL 33701-4804 | 2020-03-03 |
| 1538651419 | Carrie Ann Gann | Nurse Practitioner | 601 5th St S, St Petersburg, FL 33701-4804 | 2018-06-05 |
| 1639680614 | Lisa Jane Gillis | Medical Genetics | 601 5th St S, St Petersburg, FL 33701-4804 | 2017-10-18 |
| 1508387143 | Courtney B Hogan | Nurse Practitioner | 601 5th St S, 2nd Flr, St Petersburg, FL 33701-4804 | 2017-07-05 |
| 1962940593 | Alyssa George | Nurse Practitioner | 601 5th St S, 701, St Petersburg, FL 33701-4804 | 2017-02-02 |
| 1205379427 | Katie Leigh Mills | Nurse Practitioner | 601 5th St S, Ste 306, St Petersburg, FL 33701-4804 | 2016-11-19 |
| 1710339908 | Paul Herlan | Physician Assistant | 601 5th St S, Ste 202, St Petersburg, FL 33701-4804 | 2016-07-12 |
| 1093176190 | Samantha Rose Hunt | Nurse Practitioner | 601 5th St S, Suite 701, St Petersburg, FL 33701-4804 | 2016-03-16 |
| 1629445804 | Kelsey Grant | Nurse Practitioner | 601 5th St S, 306, St Petersburg, FL 33701-4804 | 2015-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013514603 | Tien Thuy Hoang | Pharmacist | 875 Dr M.l.k. Jr St N, St. Petersburg, FL 33701 | 2020-10-06 |
| 1851920953 | Michelle Tedrowe | Student in an Organized Health Care Education/Training Program | Bayfront Health St Petersburg Family Care Center, 700 6th Street South, St. Petersburg, FL 33701 | 2020-04-02 |
| 1164070264 | Melissa Joy Fitzpatrick | Occupational Therapist | 239 14 Ave Ne, St Petersburg, FL 33701 | 2019-09-01 |
| 1841763091 | William Carpenter Scott | Dentist | 239 2nd Ave S # 100, St Petersburg, FL 33701 | 2019-01-09 |
| 1992289318 | Westminster Senior Services, Inc. | Registered Nurse | 830 North Shore Dr. Ne, St. Petersburg, FL 33701 | 2018-09-21 |
| 1265929780 | B&b Florida Eye Care Pllc | Optometrist | 1380 4th St N, St. Petersburg, FL 33701 | 2018-04-19 |
| 1730684895 | Loraine Marie Torres Garcia | Student in an Organized Health Care Education/Training Program | Bayfront Health St Petersburg, 700 6th Street South, St Petersburg, FL 33701 | 2018-03-29 |
| 1598267445 | Vincent Malik Dehili | Psychologist | 146 2nd Street North, Suite 305, St. Petersburg, FL 33701 | 2018-03-07 |
| 1770083073 | Megan Sanborn | Nurse Practitioner | 601 5th St S Ste 304, St Petersburg, FL 33701 | 2018-02-14 |
| 1174037089 | Julius Griffin | Licensed Practical Nurse | 1115 Highland St N, Apt B, Saint Petersburg, FL 33701 | 2017-11-30 |
| Find all providers in zip 33701 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316556368 | Jacob Sidney Alexander | Student in an Organized Health Care Education/Training Program | 1663 Brightwaters Blvd Ne, St Petersburg, FL 33704-3813 | 2020-07-27 |
| 1437647641 | Eric William Yuschak | Student in an Organized Health Care Education/Training Program | 6500 38th Ave N Ste 400, St Petersburg, FL 33710-1629 | 2018-04-24 |
| 1164929774 | Omid Roostaeyan | Student in an Organized Health Care Education/Training Program | 700 6th St S Bay Bayfront, St Petersburg, FL 33701-4815 | 2018-04-10 |
| 1730684895 | Loraine Marie Torres Garcia | Student in an Organized Health Care Education/Training Program | Bayfront Health St Petersburg, 700 6th Street South, St Petersburg, FL 33701 | 2018-03-29 |
| 1083146468 | Tyler Wellman | Student in an Organized Health Care Education/Training Program | 1078 Paseo Del Rio Ne, St Petersburg, FL 33702-1457 | 2017-04-03 |
| 1326592239 | Van Le Nguyen | Student in an Organized Health Care Education/Training Program | 8001 Elbow Ln N, St Petersburg, FL 33710-4323 | 2016-08-09 |
| 1972967453 | Travis Alexander Williams | Student in an Organized Health Care Education/Training Program | 625 13th Ave Ne, St Petersburg, FL 33701-1310 | 2016-04-11 |
| 1437512969 | Weston Wall | Student in an Organized Health Care Education/Training Program | 4655 Waterford Ct Ne, St Petersburg, FL 33703-4948 | 2016-04-01 |
| 1598102329 | Bridget Narvaez | Student in an Organized Health Care Education/Training Program | 2075 Lakewood Club Dr S, Apt. A, St Petersburg, FL 33712-4978 | 2013-06-03 |
| 1205434867 | Diane Rose Bronkema | Student in an Organized Health Care Education/Training Program | 625 6th Ave S Ste 450, St Petersburg, FL 33701-4629 | 2020-10-15 |
| Find all providers in ST PETERSBURG | ||||
| City | ST PETERSBURG |
| Zip Code | 33701 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.