Individual
DEIDRA BOBBIEANN BOHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
11295
GA
363A00000X
Physician Assistant
Primary
11295
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2021
Last updated
05/21/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up