Leah Boeve, FNP
Individual provider Active NPI Family Nurse Practitioner · Coopersville, MI
NPI 1750101895 · NPPES record last updated Oct 14, 2024
Key facts
- NPI
- 1750101895
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4704314023 (MI)
- Practice address
- 675 W Randall St
Coopersville, MI 49404-1305 - Phone
- (616) 889-6011
- NPI assigned
- Oct 14, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241231000187 | MI | Practitioner - Nurse Practitioner | 5698202703 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704314023 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Randall Street Medical PC | Current |
Accepting new patients |
Locations
675 W Randall St
Coopersville, MI 49404
Phone (616) 837-9777
Interoperability endpoints
- leah.boeve.1@28754.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704314023 | MI | Yes |
Addresses
Primary practice location
675 W Randall St
Coopersville, MI 49404-1305
Mailing address
12151 Linden Dr
Marne, MI 49435-9684
Phone (616) 889-6011
Other providers in Coopersville, MI
- Shanae Bartlett
- Baruch SLS, Inc.
- Baruch SLS, Inc.
- Austin Thomas Bastien
- Valerie S Becker
- Bronson Eye Care, L.L.C
- Kimberley Bruce
- Jessica Bukrey
- Julie Kristine Bukrey
- Checordra LLC
All providers in Coopersville, MI · Family Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.