Jennifer L Boerger, FNP APNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2658-033 Issued in WI

Doing business as

Jennifer L Johnson

Practice address

8348 Washington Ave
Racine, WI 53406-3733

Phone

(262) 884-4098

Fax

(262) 884-4177

NPI assigned

Aug 5, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jennifer L Johnson Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1134138779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-647-6326",
            "fax_number": "414-671-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8348 WASHINGTON AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534063733",
            "telephone_number": "262-884-4098",
            "fax_number": "262-884-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERGER",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "FNP APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "116619-030",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "2658-033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41268700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "JOHNSON",
            "middle_name": "L",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Arnold Bissegger, D.D.S.
• William James Bjerregaard, M.D.
• Alexis Malaina Blank, OTR L
• Elaine Marie Blank, LPN
• Benjamin P. Bodven, PTA
• Lisa D Boerner, PHARMD
• Boho Pain Management and Rehabilitation LLC
• Patricia S. Bolling, N.P.
• Glen Bordak, M.D.
• Craig John Borgardt, RPH

• Nurse Practitioner in Racine, WI
• Providers in Racine, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.