MEDICARE: SHAWNA K BOSMAN ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WG0000X	General Practice Registered Nurse	AP30006011	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083726947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWNA K BOSMAN ARNP

Provider Business Mailing Address
First Line	:	4519 GRANDVIEW RD
Second Line	:
City	:	BLAINE
State	:	WA
Zip	:	98230-9640
Country	:	US
Telephone Number	:	360-371-1307
Fax Number	:

Provider Business Practice Location Address
First Line	:	8534 DEPOT RD
Second Line	:
City	:	LYNDEN
State	:	WA
Zip	:	98264-9598
Country	:	US
Telephone Number	:	360-354-8209
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	08/14/2008

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