Doctor Name: | ROBIN JAYNE BOHANAN |
NPI Number: | 1205069390 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | SP010414 |
Business Practice Address: | 32 W Foothills Dr Drums, PA - 182222407 |
Business Phone Number: | 5077885000 |
Business Fax Number: | 5707882325 |
Mailing Address: | 6 Division St, MOUNTAIN TOP |
State: | PA |
Postal Code: | 187071105 |
Phone Number: | 5702615065 |
Fax Number: | 5705016203 |
NPI Enumeration Date: | 08/24/2009 |
NPI Last Update Date: | 06/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | SP010414 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |