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NPI Code Detail

MEDICARE: SAUNDRA M BOSCHE RN/NP

MEDICARE: SAUNDRA M BOSCHE RN/NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerA810205MS
2363LF0000XFamily Nurse Practitioner140261TN
3363LF0000XFamily Nurse Practitioner8428TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
383461OTHERARBCBS AR
44125245OTHERTNBCBS TN

General Provider Information

NPI Number : 1699752311
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAUNDRA M BOSCHE RN/NP
Provider Business Mailing Address
First Line : 100 N HUMPHREYS BLVD
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-2146
Country : US
Telephone Number : 901-683-0055
Fax Number : 901-685-2969
Provider Business Practice Location Address
First Line : 100 N HUMPHREYS BLVD
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-2146
Country : US
Telephone Number : 901-683-0055
Fax Number : 901-685-2969
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2005
Last Update Date : 10/24/2007

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