Provider Demographics
NPI:1609504257
Name:BOHMAN, JOSIE JEANNE
Entity Type:Individual
Prefix:
First Name:JOSIE
Middle Name:JEANNE
Last Name:BOHMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 HEARD AVENUE, BLDG 556
Mailing Address - Street 2:ROOM 127
Mailing Address - City:SCHOFIELD BARRACKS
Mailing Address - State:HI
Mailing Address - Zip Code:96857
Mailing Address - Country:US
Mailing Address - Phone:808-438-5555
Mailing Address - Fax:
Practice Address - Street 1:334 HEARD AVENUE, BLDG 556
Practice Address - Street 2:ROOM 127
Practice Address - City:SCHOFIELD BARRACKS
Practice Address - State:HI
Practice Address - Zip Code:96857
Practice Address - Country:US
Practice Address - Phone:808-438-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist