Individual
MARY HYACINTH BODENHEIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER-C
Contact information
Practice address
212 S FLORIDA ST, BUSHNELL, FL 33513-6703
(352) 793-2441
(352) 793-3282
Mailing address
212 S FLORIDA ST, BUSHNELL, FL 33513-6703
(352) 793-2441
(352) 793-3282
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN1782662
FL
Other
Enumeration date
09/11/2018
Last updated
05/28/2019
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