STEPHANIE BOHANNON (NPI# 1104459114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104459114 |
Entity Type | Individual |
Full Name | STEPHANIE BOHANNON |
Other Name | STEPHANIE PARKER |
Credential | PMHNP, APRN |
Practice Address |
112 W Center St Ste 201 Fayetteville AR 72701-6073 |
Mailing Address |
4517 W Divide Dr Fayetteville AR 72704-4020 |
Practice Telephone | 4793167770 |
Mailing Telephone | 4793015550 |
Enumeration Date | 2020-02-18 |
Last Update Date | 2020-02-18 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
124030 | AR | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
112 W CENTER ST STE 201 |
City | FAYETTEVILLE |
State | AR |
Zip Code | 72701-6073 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629546510 | Wellness & Courage | Counselor | 112 W Center St Ste 201, Fayetteville, AR 72701-6073 | 2018-11-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588213417 | Biggers Counseling, LLC | Social Worker | 349 S Hill Ave, Fayetteville, AR 72701 | 2019-09-04 |
1235603200 | Arkansas Holistic Health Care Chiropractic | Chiropractor | 2618 Mlk Jr Blvd, Fayetteville, AR 72701 | 2019-01-14 |
1225520828 | Jacoby Markie Clemons | Specialist/Technologist | 1201 West Leroy Pond Dr, Fayetteville, AR 72701 | 2018-05-31 |
1952892390 | Ambur Dryer | Specialist/Technologist | 994 W Mlk Jr. Blvd., Fayetteville, AR 72701 | 2018-05-22 |
1851814230 | Blakely Low | Psychologist | 1229 Meadow Street Suite #221, Jones Family Center for Student-athlete Success, Fayetteville, AR 72701 | 2017-07-18 |
1518496215 | Van Michael Mcqueen Jr. | Dentist | 640 N Garland Ave # 104, Fayetteville, AR 72701 | 2017-06-06 |
1407204217 | Kenna Megan Hodeaux | Specialist/Technologist | 1201 Leroy Pond Drive, Sports Medicine Department, Fayetteville, AR 72701 | 2016-06-02 |
1740634435 | Crystal Susan Rofkahr | Psychologist | 26 E Meadow St Ste 3, Fayetteville, AR 72701 | 2016-04-19 |
1942663521 | Satoshi IIda | Specialist/Technologist | 1010 S Dunn Ave., Apt 205a, Fayetteville, AR 72701 | 2016-04-01 |
1992163901 | Dr Don M Chaney Dds Pa | Dentist | 1826 N. Crossover Road, Suite 2, Fayetteville, AR 72701 | 2016-02-04 |
Find all providers in zip 72701 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477189157 | Fatimat Olumayowa Olufunmilayo Agbojeyin | Nurse Practitioner | 105 Emerald Lake Ct, Fayetteville, GA 30215-7748 | 2020-03-13 |
1548821069 | Asic Behavioral Health, Pllc | Nurse Practitioner | 6977 Nexus Ct Ste 103, Fayetteville, NC 28304-2651 | 2019-06-25 |
1245794387 | Stacey Lasandra Mitchell | Nurse Practitioner | 1415 Highway 85 N Ste 310-390, Fayetteville, GA 30214-7738 | 2019-01-23 |
1417206491 | Casey J Scott | Nurse Practitioner | 4001 Cumberland Rd, Fayetteville, NC 28306-6703 | 2012-09-05 |
1972510519 | Melodie W. Stembridge | Nurse Practitioner | 1100 No. College Avenue, Vhsa, Fayetteville, AR 72703 | 2006-08-02 |
1053313536 | Margaret Jean Davis | Nurse Practitioner | 4276 Legend Avenue, Fayetteville, NC 28303-3497 | 2005-08-15 |
1811517469 | Ifeoma Nnani | Nurse Practitioner | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2020-04-23 |
1497380414 | Andrew Eisele | Nurse Practitioner | 1955 W Truckers Dr, Fayetteville, AR 72704-5637 | 2020-03-10 |
1417582545 | Latoya Harley-dowden | Nurse Practitioner | 806 Hay St, Fayetteville, NC 28305-5312 | 2020-03-09 |
1891346664 | Miriam Elyse Koesy | Nurse Practitioner | 4253 N Crossover Rd, Fayetteville, AR 72703-4593 | 2019-09-24 |
Find all providers in FAYETTEVILLE |
City | FAYETTEVILLE |
Zip Code | 72701 |
Please comment or provide details below to improve the information on STEPHANIE BOHANNON.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.