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Individual
STEPHANIE L BOHANNON
Active
Individual
STEPHANIE L BOHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP, APRN
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
124030
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259152758
—
AR
05
—
420098635
—
MO
Enumeration date
02/18/2020
Last updated
09/21/2022
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