MEDICARE: WHITNEY MARIE BOSTON APRN

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	363LF0000X	Family Nurse Practitioner	1000641	CO

General Provider Information

NPI Number	:	1619776838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHITNEY MARIE BOSTON APRN

Provider Business Mailing Address
First Line	:	4870 W OLD FARM CIR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80917-1005
Country	:	US
Telephone Number	:	719-313-0556
Fax Number	:

Provider Business Practice Location Address
First Line	:	4870 W OLD FARM CIR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80917-1005
Country	:	US
Telephone Number	:	719-313-0556
Fax Number	:

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

Provider Enumeration Date	:	03/11/2025
Last Update Date	:	03/11/2025

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Directions to “ WHITNEY MARIE BOSTON APRN” Practice Location

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