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NPI Code Detail

MEDICARE: MRS. DANA NUNES BOSLAU RN

MEDICARE: MRS. DANA NUNES BOSLAU RN
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
1163WC1500XCommunity Health Registered Nurse079906NC

General Provider Information

NPI Number : 1457457145
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DANA NUNES BOSLAU RN
Provider Business Mailing Address
First Line : 2050 RIVERSHORE RD
Second Line :
City : ELIZABETH CITY
State : NC
Zip : 27909-6212
Country : US
Telephone Number : 252-338-8072
Fax Number :
Provider Business Practice Location Address
First Line : 711 ROANOKE AVE
Second Line :
City : ELIZABETH CITY
State : NC
Zip : 27909-5643
Country : US
Telephone Number : 252-338-4412
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2006
Last Update Date : 07/08/2007

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