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NPI 1467437178

NPI 1467437178 : PERRY KENT BOHANON MSN, APRN, BC : EDGEWOOD, KY

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General NPI Number Information
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    NPI Number           |    1467437178
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    Entity Type          |    Individual 
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    Provider Name        |    PERRY KENT BOHANON MSN, APRN, BC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/14/2005
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    Last Update Date     |    11/17/2022
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Provider Practice Location Address
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    Address Line         |    334 THOMAS MORE PARKWAY 
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    City                 |    EDGEWOOD
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    State                |    KY
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    Zip                  |    41017-3464
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    Country              |    US
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    Telephone            |    859-301-5901
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    Fax                  |    859-301-5940
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Provider Business Mailing Address
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    Address Line         |    PO BOX 635283 
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    City                 |    CINCINNATI
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    State                |    OH
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    Zip                  |    45263-5283
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    Country              |    US
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    Telephone            |    859-301-5901
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    Fax                  |    859-301-5940
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    364SP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Clinical Nurse Specialist
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    License Number       |    3002807
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    License Number State |    KY
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Taxonomy #2
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    Taxonomy Code        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    3002807
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    License Number State |    KY
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Taxonomy #3
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    Taxonomy Code        |    364SP0809X
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    Taxonomy Name        |    Adult Psychiatric/Mental Health Clinical Nurse Specialist
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    License Number       |    3002807
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    License Number State |    KY
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Taxonomy #4
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    Taxonomy Code        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    3002807
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    License Number State |    KY
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