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General NPI Number Information
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NPI Number | 1790084176
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Entity Type | Individual
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Provider Name | NIKOLE LYN BOSHONEK MSN, FNP-BC, DIPACLM
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Gender | Female
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Dates
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Enumeration Date | 03/24/2011
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 104 CHURCH ST SE STE 104
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City | LEESBURG
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State | VA
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Zip | 20175-3055
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Country | US
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Telephone | 571-440-2755
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Fax | 800-420-3682
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Provider Business Mailing Address
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Address Line | 43604 EMERALD DUNES PL
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City | LEESBURG
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State | VA
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Zip | 20176-3967
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Country | US
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Telephone | 757-619-4846
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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 | 0024169311
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License Number State | VA
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