Healthcare Provider Details

I. General information

NPI: 1730650581
Provider Name (Legal Business Name): COURTNEY BOSWELL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2018
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16538 GLENDALE DR
WESTFIELD IN
46074-4439
US

IV. Provider business mailing address

16538 GLENDALE DR
WESTFIELD IN
46074-4439
US

V. Phone/Fax

Practice location:
  • Phone: 317-691-1056
  • Fax:
Mailing address:
  • Phone: 317-691-1056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71008586A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: