Individual
JENNIFER BOHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
215 KIRKLAND RD, COVINGTON, GA 30016-3318
(678) 209-2770
Mailing address
105 JERSEY RD, OXFORD, GA 30054-3714
(770) 656-0691
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN312495
GA
Other
Enumeration date
11/04/2022
Last updated
11/04/2022
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