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General NPI Number Information
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NPI Number | 1649985854
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Entity Type | Individual
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Provider Name | MARY BOSQUE-HAMILTON
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Gender | Female
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Dates
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Enumeration Date | 01/23/2023
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | PO BOX 41
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City | BOWLING GREEN
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State | SC
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Zip | 29703-0041
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Country | US
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Telephone | 803-716-2554
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 41
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City | BOWLING GREEN
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State | SC
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Zip | 29703-0041
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Country | US
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Telephone | 803-716-2554
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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 | 27076
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License Number State | SC
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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 | 5018465
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License Number State | NC
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