Healthcare Provider Details

I. General information

NPI: 1487967386
Provider Name (Legal Business Name): HEATHER H. BOSCIA N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N ELAM AVE
GREENSBORO NC
27403-1118
US

IV. Provider business mailing address

2991 CROUSE LN
BURLINGTON NC
27215-8833
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-1100
  • Fax:
Mailing address:
  • Phone: 336-586-0994
  • Fax: 336-586-9363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number202073
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number202073
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: