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General NPI Number Information
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NPI Number | 1598846669
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Entity Type | Individual
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Provider Name | JENIFER KAY BOSSERT O.D.
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Gender | Female
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1329 LUSITANA ST POB II, STE 806
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City | HONOLULU
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State | HI
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Zip | 96813-2429
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Country | US
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Telephone | 808-526-0030
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Fax |
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Provider Business Mailing Address
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Address Line | 2051 KULA ST
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City | HONOLULU
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State | HI
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Zip | 96817-2137
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Country | US
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Telephone | 808-595-4151
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | HI323
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License Number State | HI
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