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General NPI Number Information
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NPI Number | 1235579046
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Entity Type | Individual
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Provider Name | WILLIAM BOSOMPEM RN
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Gender | Male
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Dates
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Enumeration Date | 06/26/2013
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Last Update Date | 04/12/2024
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Provider Practice Location Address
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Address Line | CMR 459 BOX 19908
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City | APO
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State | AE
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Zip | 09139
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Country | US
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Telephone | 4909514697978
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Fax |
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Provider Business Mailing Address
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Address Line | CMR 411 BOX 5992
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City | APO
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State | AE
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Zip | 09112-1060
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Country | US
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Telephone |
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 26NR11493000
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License Number State | NJ
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