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General NPI Number Information
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NPI Number | 1194169235
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Entity Type | Individual
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Provider Name | KANS BOOZ LEWIS NP
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Gender | Male
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Dates
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Enumeration Date | 04/19/2013
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Last Update Date | 04/19/2013
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Provider Practice Location Address
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Address Line | 41 JERICHO RD
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City | BERLIN
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State | NH
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Zip | 03570-1315
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Country | US
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Telephone | 603-348-5625
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Fax |
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Provider Business Mailing Address
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Address Line | 41 JERICHO RD
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City | BERLIN
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State | NH
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Zip | 03570-1315
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Country | US
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Telephone | 603-348-5625
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F306305-1
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License Number State | NY
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