MEDICARE: WILLIAM BOSTON

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	364SF0001X	Family Health Clinical Nurse Specialist	AP07997	LA

General Provider Information

NPI Number	:	1487063590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM BOSTON

Provider Business Mailing Address
First Line	:	18448 MAGNOLIA BRIDGE RD STE A
Second Line	:
City	:	GREENWELL SPRINGS
State	:	LA
Zip	:	70739-4626
Country	:	US
Telephone Number	:	225-256-0063
Fax Number	:	225-256-0217

Provider Business Practice Location Address
First Line	:	18448 MAGNOLIA BRIDGE RD STE A
Second Line	:
City	:	GREENWELL SPRINGS
State	:	LA
Zip	:	70739-4626
Country	:	US
Telephone Number	:	225-256-0063
Fax Number	:	225-256-0217

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

Provider Enumeration Date	:	08/04/2014
Last Update Date	:	08/21/2024

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Directions to “ WILLIAM BOSTON ” Practice Location

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