Healthcare Provider Details

I. General information

NPI: 1417533530
Provider Name (Legal Business Name): PEYTON BOSCO ORSI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2021
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 CHANCELLOR DR STE 225
CRESTVIEW HILLS KY
41017-3915
US

IV. Provider business mailing address

2865 CHANCELLOR DR STE 225
CRESTVIEW HILLS KY
41017-3915
US

V. Phone/Fax

Practice location:
  • Phone: 859-341-5400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number11012212
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4011268
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: