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General NPI Number Information
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NPI Number | 1033801840
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Entity Type | Individual
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Provider Name | ANGELA BOSSIER LPN
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Gender | Female
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 5520 JOHNSTON ST # K635
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City | LAFAYETTE
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State | LA
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Zip | 70503-5138
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Country | US
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Telephone | 337-255-2480
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1145
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City | SCOTT
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State | LA
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Zip | 70583-1145
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Country | US
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Telephone | 337-255-2480
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 20150080
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 20150080
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License Number State | LA
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