Individual
CATHY L BOHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1999 BENT CREEK WAY SW, ATLANTA, GA 30311-3826
(404) 509-0128
Mailing address
1999 BENT CREEK WAY SW, ATLANTA, GA 30311-3826
(404) 509-0128
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
823544238
IRS
GA
Enumeration date
11/29/2017
Last updated
11/29/2017
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