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General NPI Number Information
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NPI Number | 1336135557
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Entity Type | Individual
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Provider Name | AMY LYNN BOSHOVEN NP
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Gender | Female
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Dates
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Enumeration Date | 09/22/2005
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Last Update Date | 12/09/2022
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Provider Practice Location Address
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Address Line | 15146 16TH AVE
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City | MARNE
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State | MI
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Zip | 49435-9605
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Country | US
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Telephone | 616-288-6970
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Fax | 616-341-6013
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Provider Business Mailing Address
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Address Line | 15146 16TH AVE
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City | MARNE
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State | MI
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Zip | 49435-9605
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Country | US
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Telephone | 616-288-6970
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Fax | 616-341-6013
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4704199423
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License Number State | MI
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