Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 2018010293 | MO |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 2018010293 | MO |
NPI | 1174904544 |
---|---|
Provider Name | Dr. Nathan L Boehr |
First Address | Kansas City, MO 64110-2735 |
Second Address | Kansas City, MO 64110-2735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2015 |
Last Update Date | 10/08/2020 |