# SUSAN M BOSE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1922070200
- **Gender:** F
- **Credential:** ANP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 695571 | TX | Yes |

## Other

- **Enumeration date:** 02/02/2006
- **Last updated:** 01/30/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 163223403 | — | TX |
| 01 | — | 8Y1394 | BC & BS | TX |