ALLYSSA BOHANAN (NPI# 1437572120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437572120 |
| Entity Type | Individual |
| Full Name | ALLYSSA BOHANAN |
| Practice Address |
1934 Niles Cortland Rd Ne Ste B Warren OH 44484-1055 |
| Practice Telephone | 3308414032 |
| Practice Fax Number | 3308414381 |
| Mailing Telephone | 3308414032 |
| Mailing Fax Number | 3308414381 |
| Enumeration Date | 2014-01-30 |
| Last Update Date | 2020-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
APRN.CNP.024749 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0364989 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 13203 N 103rd Ave Ste H5, Sun City, AZ 853513032 | 6237774747 | 6237774748 |
| 14420 W Meeker Blvd Ste 211, Sun City West, AZ 853755288 | 6237774747 | 6237774748 |
| Street Address |
1934 NILES CORTLAND RD NE STE B |
| City | WARREN |
| State | OH |
| Zip Code | 44484-1055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881723906 | Lokesh B Ningegowda | Anesthesiology | 1934 Niles Cortland Rd Ne Ste B, Warren, OH 44484-1055 | 2007-03-05 |
| 1669759965 | Dana Jo Walker | Nurse Practitioner | 1934 Niles Cortland Rd Ne Ste B, Warren, OH 44484-1055 | 2011-11-15 |
| 1922262641 | Maged Farouk Fouad | Anesthesiology | 1934 Niles Cortland Rd Ne Ste B, Warren, OH 44484 | 2008-07-11 |
| 1346422615 | Marisa Marie Wynne | Anesthesiology | 1934 Niles Cortland Rd Ne Ste B, Warren, OH 44484-1055 | 2007-11-28 |
| 1891829560 | Kimberly Lynn Underwood | Physician Assistant | 1934 Niles Cortland Rd Ne Ste B, Warren, OH 44484-1055 | 2007-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205446283 | Jessica Toot | Behavior Technician | Oakwood Counseling Center LLC, 1704 North Road Se, Warren, OH 44484 | 2020-08-05 |
| 1558857060 | Quantina Louise Thomas | Home Health | 1548oak Knoll Se, Warren, OH 44484 | 2018-07-09 |
| 1033609706 | Justin A Houy | Massage Therapist | 8345 E. Market St. Suite C, The Chiropractic and Functional Neurology Center, Warren, OH 44484 | 2018-05-17 |
| 1679091359 | Ester Mae Butler | Nurse's Aide | 2228 Draper Avenue Se, Warren, OH 44484 | 2017-09-01 |
| 1477070811 | Amanda Lynn Heberling | Occupational Therapy Assistant | 8128 Kenyon Dr., Warren, OH 44484 | 2017-08-26 |
| 1790213650 | Joyce A Mechling | Licensed Practical Nurse | 2737 Youngstown Rd., Warren, OH 44484 | 2017-05-23 |
| 1598206898 | Stan Catullo | Substance Abuse Rehabilitation Facility | 2737 Youngstown Warren Road Se, Warren, OH 44484 | 2017-03-20 |
| 1679014054 | Pamela M Lang | Pharmacist | 1977 Niles Rd S.e., Genoa A Qol Healthcare Company, Warren, OH 44484 | 2017-03-17 |
| 1922454800 | Jeremy Michael Capetillo | Dentist | 8740 E Market St Ste 1, Warren, OH 44484 | 2016-05-10 |
| 1215311865 | Jessica Dawn Harris | Physical Therapy Assistant | 1926 Ridge Avenue, Warren, OH 44484 | 2015-07-14 |
| Find all providers in zip 44484 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932737731 | Dominick Lawrence Flarey | Nurse Practitioner | 2400 Niles Cortland Rd Se Ste 4, Warren, OH 44484-3869 | 2020-03-29 |
| 1598813727 | Catherine Luk | Nurse Practitioner | 9 Jennifer Ln, Warren, NJ 07059-6913 | 2007-01-05 |
| 1124492723 | Danielle Hurst | Nurse Practitioner | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2015-11-19 |
| 1790164176 | Petra Holka | Nurse Practitioner | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2015-05-19 |
| 1932502705 | Kristin Elaine Boyd | Nurse Practitioner | 2760 Parkman Rd Nw, Warren, OH 44485-1635 | 2014-10-07 |
| 1467706457 | Lisa A. White | Nurse Practitioner | 1615 N River Rd Ne, Warren, OH 44483-2437 | 2012-10-30 |
| 1972886950 | Donna Elaine Kaiser | Nurse Practitioner | 8600 E Market St, Suite 8, Warren, OH 44484-2375 | 2011-09-26 |
| 1871892760 | Sara Tandoc | Nurse Practitioner | 25600 Schoenherr Rd, Warren, MI 48089-1447 | 2011-03-18 |
| 1194058966 | Kathleen Jane Leigh-simms | Nurse Practitioner | 2 Crescent Park W, Warren, PA 16365 | 2009-09-11 |
| 1518081686 | Colleen Ann Mikula | Nurse Practitioner | 28800 Ryan Rd, Suite 320, Warren, MI 48092-4272 | 2007-03-16 |
| Find all providers in WARREN | ||||
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| 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.