Brenna B Bohatec, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0024170794 Issued in VA

Practice address

210 Medical Park Blvd
Suite 200
Petersburg, VA 23805-9338

Phone

(804) 431-1100

Fax

(804) 862-1094

NPI assigned

Apr 11, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1346683182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7202 GLEN FOREST DR",
            "address_2": "SUITE 200",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263781",
            "telephone_number": "804-676-2024",
            "fax_number": "804-673-1796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MEDICAL PARK BLVD",
            "address_2": "SUITE 200",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059338",
            "telephone_number": "804-431-1100",
            "fax_number": "804-862-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHATEC",
        "first_name": "BRENNA",
        "middle_name": "B",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-11",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024170794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.