NPI 1093639015 · live from the CMS NPI Registry
Courtney Ann Bohnert, PA-C, RD, LD
Physician Assistant in Cape Girardeau, MO. National Provider Identifier 1093639015, active.
NPI record
| NPI | 1093639015 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 24 S Mount Auburn Rd, Cape Girardeau, MO 63703 |
| Practice phone | 573-331-5544 |
| Mailing address | Po Box 801143, Kansas City, MO 64180 |
| Enumerated | August 5, 2026 |
| Last updated | October 8, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered | 133V00000X | 2022016526 (MO) |
| Physician Assistant primary | 363A00000X | 2026046134 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.