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General NPI Number Information
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NPI Number | 1235855388
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Entity Type | Individual
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Provider Name | BO K. ROMERO
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Gender | Female
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Dates
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Enumeration Date | 10/19/2022
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 112 BILLY MITCHELL DR
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City | BARKSDALE AFB
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State | LA
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Zip | 71110-2116
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Country | US
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Telephone | 202-999-8013
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Fax |
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Provider Business Mailing Address
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Address Line | 1541 KINGS HWY
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City | SHREVEPORT
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State | LA
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Zip | 71103-4228
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 70388
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 238360
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License Number State | LA
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