Individual
JESSICA FAYE BOHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
301 DIVISION ST, GREENVILLE, TX 75401-4101
(903) 453-3385
Mailing address
4161 COUNTY ROAD 2727, CADDO MILLS, TX 75135-5624
(903) 461-4100
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1179922
TX
Other
Enumeration date
12/11/2024
Last updated
04/09/2026
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