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NPI Code Detail

MEDICARE: MS. CARRIE BOSSMAN

MEDICARE:  MS. CARRIE  BOSSMAN
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
11041C0700XClinical Social Worker4918SD

General Provider Information

NPI Number : 1932570082
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CARRIE BOSSMAN
Provider Business Mailing Address
First Line : 677 CATHEDRAL DR
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-6018
Country : US
Telephone Number : 605-755-5276
Fax Number :
Provider Business Practice Location Address
First Line : 677 CATHEDRAL DR
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-6018
Country : US
Telephone Number : 605-755-5276
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2015
Last Update Date : 11/09/2022

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Directions to “ MS. CARRIE BOSSMAN ” Practice Location

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