Individual
ALLYSSA BOHANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1934 NILES CORTLAND RD NE STE B, WARREN, OH 44484-1055
(330) 841-4032
(330) 841-4381
Mailing address
1934 NILES CORTLAND RD NE STE B, WARREN, OH 44484-1055
(330) 841-4032
(330) 841-4381
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN.CNP.024749
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0364989
—
OH
Enumeration date
01/30/2014
Last updated
06/09/2020
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