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Individual

MS. THERESA SUSI BOHENEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
210 LORNA DR, HATBORO, PA 19040-1706
(215) 441-0865
Mailing address
210 LORNA DR, HATBORO, PA 19040-1706
(215) 441-0865

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN226141L
PA
363LA2200X
Adult Health Nurse Practitioner
Primary
SP010997
PA

Other

Enumeration date
08/14/2011
Last updated
08/14/2011
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