Individual
DR. KATHLEEN SUE BOHANON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4090 STONEBRIDGE PT, COLORADO SPRINGS, CO 80904-4704
(719) 685-0585
Mailing address
4090 STONEBRIDGE PT, COLORADO SPRINGS, CO 80904-4704
(719) 685-0585
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
35042157B
OH
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
38505
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
92524354
—
CO
Enumeration date
07/05/2005
Last updated
07/08/2007
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