Basic Information
| Provider Information | |||||||||
| NPI: | 1518151539 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOCHENEK | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | CHRISTINE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8069 ODONNELL DR | ||||||||
| Address2: | |||||||||
| City: | GROSSE ILE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481381142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346759151 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1700 BIDDLE AVE | ||||||||
| Address2: | |||||||||
| City: | WYANDOTTE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481927205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7342842026 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2007 | ||||||||
| LastUpdateDate: | 02/13/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 4704196318 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.