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NPI Code Detail

MEDICARE: LINDA ANNE BOSSE PMHNP

MEDICARE: LINDA ANNE BOSSE PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAP10739AZ

General Provider Information

NPI Number : 1770092496
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA ANNE BOSSE PMHNP
Provider Business Mailing Address
First Line : 4155 N VAL VERDE WAY
Second Line :
City : PRESCOTT VALLEY
State : AZ
Zip : 86314-5462
Country : US
Telephone Number : 602-697-8207
Fax Number :
Provider Business Practice Location Address
First Line : 117 NW 8TH ST
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-5560
Country : US
Telephone Number : 503-379-0208
Fax Number : 503-662-6068
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2017
Last Update Date : 02/18/2022

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