Healthcare Provider Details

I. General information

NPI: 1376342840
Provider Name (Legal Business Name): LAURA BOSKO PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 CURRIE HALL PKWY STE C
KENT OH
44240-4387
US

IV. Provider business mailing address

174 CURRIE HALL PKWY STE C
KENT OH
44240-4387
US

V. Phone/Fax

Practice location:
  • Phone: 330-676-0313
  • Fax:
Mailing address:
  • Phone: 330-778-8264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0038823
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: