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General NPI Number Information
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NPI Number | 1235404146
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Entity Type | Individual
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Provider Name | JANELLE BOSSE PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/12/2012
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Last Update Date | 09/11/2020
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Provider Practice Location Address
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Address Line | 125 METRO CENTER BLVD STE 2000
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City | WARWICK
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State | RI
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Zip | 02886-1785
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Country | US
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Telephone | 401-432-2520
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Fax |
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Provider Business Mailing Address
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Address Line | 125 METRO CENTER BLVD STE 2000
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City | WARWICK
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State | RI
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Zip | 02886-1785
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Country | US
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Telephone | 401-432-2520
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-03691
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA00939
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA7588
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA00939
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License Number State | RI
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Taxonomy #5
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 0010-03691
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA7588
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License Number State | MA
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