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General NPI Number Information
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NPI Number | 1184590622
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Entity Type | Individual
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Provider Name | KAHLICE BOSTICK
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Gender | Female
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Dates
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Enumeration Date | 10/13/2025
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 1200 N DUPONT HWY
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City | DOVER
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State | DE
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Zip | 19901-2202
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Country | US
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Telephone | 302-857-6921
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Fax |
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Provider Business Mailing Address
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Address Line | 26 PROSPECT AVE APT F3
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City | NORWALK
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State | CT
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Zip | 06850-3246
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Country | US
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Telephone | 203-727-6362
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | DE
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