Provider Demographics
NPI:1043882525
Name:BOEHLKE, ERIKA ROSE
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:ROSE
Last Name:BOEHLKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 NIELSEN RD
Mailing Address - Street 2:
Mailing Address - City:ALTAMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12009-4601
Mailing Address - Country:US
Mailing Address - Phone:518-729-7121
Mailing Address - Fax:
Practice Address - Street 1:2995 CURRY RD EXT
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-2801
Practice Address - Country:US
Practice Address - Phone:518-836-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY775273-01163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool