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Individual
SUSAN M BOSE
Active
Individual
SUSAN M BOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
695571
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163223403
—
TX
01
—
8Y1394
BC & BS
TX
Enumeration date
02/02/2006
Last updated
01/30/2012
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