Individual
MS. AMANDA M BOHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
12110 LEBANON RD, SHARONVILLE, OH 45241-1739
(513) 853-9700
Mailing address
12110 LEBANON RD, SHARONVILLE, OH 45241-1739
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
COA.17292-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0135028
—
OH
Enumeration date
06/19/2015
Last updated
09/20/2021
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