Michelle Ann Bohlen, GNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

17543 Issued in CA

Practice address

11301 Wilshire Blvd
BLDG 5000 RM 4080
Los Angeles, CA 90073-1003

Phone

(818) 335-1114

NPI assigned

Jun 18, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1326209883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17224 MIDWOOD DR",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913442452",
            "telephone_number": "818-335-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD",
            "address_2": "BLDG 5000 RM 4080",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900731003",
            "telephone_number": "818-335-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHLEN",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "17543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janelle Bogran, RN, FNP
• Ninareh Boguspour
• Brittni Bohan, NP
• Ian Yuan-Jian Bohannon, LCSW
• Keara Bohannon, MD
• Molly Bohlke
• Livia G Bohman, MD
• Sharla Bohman
• Deborah Ann Bohn, MPT
• Pamela Summit Bohn, M.D.

• Gerontology Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.