Provider Demographics
NPI:1396871620
Name:BOHAN, KARENBETH HEIKKINEN (PHARMD, BCPS)
Entity type:Individual
Prefix:DR
First Name:KARENBETH
Middle Name:HEIKKINEN
Last Name:BOHAN
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-8494
Mailing Address - Country:US
Mailing Address - Phone:570-275-5887
Mailing Address - Fax:570-408-7729
Practice Address - Street 1:WYOMING VALLEY HEALTHCARE SYSTEM
Practice Address - Street 2:WILKES-BARRE GENERAL HOSPITAL
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18766-0001
Practice Address - Country:US
Practice Address - Phone:570-408-4292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP037058R1835P1200X
MEPR41731835P1200X
PARPI0000031835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy