Individual
JESSICA LYNN BOHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC, FNP-BC
Contact information
Practice address
1601 FAIR RD STE 600, STATESBORO, GA 30458-0800
(912) 681-4911
Mailing address
4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325
(615) 465-7000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5010805
NC
363L00000X
Nurse Practitioner
RN208956
GA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN208956
GA
Other
Enumeration date
08/03/2018
Last updated
01/31/2022
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