| NPI | 1598126179 |
|---|---|
| Former Name | TEMICA TERESE BOHANNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN157878) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN157878) |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2016-03-10 |