Bohanon, Jennifer N

Bohanon, Jennifer N is an individual health care provider with primary practice located at 2232 Wilborn Ave Suite A, South Boston VA 24592-1662. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Bohanon, Jennifer N can be contacted via phone (434) 572-8977.

Contact Information

Primary practice address
2232 Wilborn Ave Suite A South Boston VA 24592-1662
Phone: (434) 572-8977
Fax: (434) 572-2510
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0110001842 Virginia

Profile Details

NPI number 1316954597
LBN Legal business name Bohanon, Jennifer N
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2006
Last updated Dec 11th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316954597 NPPES
Virginia MEDICAID P00167510

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