Healthcare Provider Details

I. General information

NPI: 1962617803
Provider Name (Legal Business Name): JANET ANDREWS BOHMULLER RN, CCM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHERRY POINT NAVAL HOSPITAL BLDG. 4389
CHERRY POINT NC
28533
US

IV. Provider business mailing address

120 POINT RD
NEWPORT NC
28570-6134
US

V. Phone/Fax

Practice location:
  • Phone: 252-466-0266
  • Fax:
Mailing address:
  • Phone: 252-240-1478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number119224
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: