Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35631 | AZ |
N | 111NI0900X | Internist | 35631 | AZ |
Y | 207RH0002X | Hospice and Palliative Medicine | 35631 | AZ |
NPI | 1134151566 |
---|---|
Provider Name | Jeanette A Boohene |
First Address | Memphis, TN 38103-5513 |
Second Address | Scottsdale, AZ 85260-2717 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 13/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
559816 | (05) | AZ |