Provider Demographics
NPI:1710592225
Name:BOHO, BRANDI MICHELLE (CNA)
Entity Type:Individual
Prefix:MISS
First Name:BRANDI
Middle Name:MICHELLE
Last Name:BOHO
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 KEYES GAP RD
Mailing Address - Street 2:
Mailing Address - City:HARPERS FERRY
Mailing Address - State:WV
Mailing Address - Zip Code:25425-6279
Mailing Address - Country:US
Mailing Address - Phone:304-724-8378
Mailing Address - Fax:
Practice Address - Street 1:559 KEYES GAP RD
Practice Address - Street 2:
Practice Address - City:HARPERS FERRY
Practice Address - State:WV
Practice Address - Zip Code:25425-6279
Practice Address - Country:US
Practice Address - Phone:304-724-8378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker