Individual
STACEY R BOSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 BRENNER DR, KANSAS CITY, KS 66104-1163
(913) 322-4900
Mailing address
325 SW FRAZIER AVE, TOPEKA, KS 66606-1963
(785) 232-5005
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
53-82585
KS
Other
Enumeration date
06/16/2014
Last updated
10/03/2023
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