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NPI Code Detail

MEDICARE: JENNIFER MICHELLE BOSWELL FNP

MEDICARE: JENNIFER MICHELLE BOSWELL FNP
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
1363LF0000XFamily Nurse PractitionerAP140085TX
2363L00000XNurse PractitionerAP140085TX

General Provider Information

NPI Number : 1932715133
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER MICHELLE BOSWELL FNP
Provider Business Mailing Address
First Line : 1540 E MAIN ST
Second Line :
City : ALLEN
State : TX
Zip : 75002-4486
Country : US
Telephone Number : 214-383-9765
Fax Number :
Provider Business Practice Location Address
First Line : 1540 E MAIN ST
Second Line :
City : ALLEN
State : TX
Zip : 75002-4486
Country : US
Telephone Number : 214-383-9765
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2020
Last Update Date : 07/04/2022

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