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General NPI Number Information
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NPI Number | 1376538074
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Entity Type | Individual
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Provider Name | PATRICIA K BOZEMAN APRN
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Gender | Female
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Dates
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Enumeration Date | 09/19/2005
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Last Update Date | 09/28/2010
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Provider Practice Location Address
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Address Line | 85 SEYMOUR ST SUITE 911
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City | HARTFORD
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State | CT
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Zip | 06106-5501
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Country | US
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Telephone | 860-522-4158
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Fax | 860-524-2652
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Provider Business Mailing Address
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Address Line | 85 SEYMOUR ST SUITE 911
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City | HARTFORD
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State | CT
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Zip | 06106-5501
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Country | US
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Telephone | 860-522-4158
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Fax | 860-524-2652
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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 | 364SM0705X
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Taxonomy Name | Medical-Surgical Clinical Nurse Specialist
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License Number | 003251
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 003251
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License Number State | CT
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