JUSTIN BOHANNAN

LAKE CHARLES, LA
NPI1124695408
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LA2100X Nurse Practitioner, Acute Care
(Licence: LA  219004)
Enumeration Date2021-06-07
Last Update Date2022-02-03
Business Address
JUSTIN BOHANNAN AG-ACNP
2770 3RD AVE STE 350
LAKE CHARLES, LA 70601-0404
Phone number: 337-494-2750
Mailing Address
JUSTIN BOHANNAN AG-ACNP
PO BOX 122309 DEPT 2309
DALLAS, TX 75312-0001
Phone number: 337-494-2772
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