Individual
KATIE LYNNE STYKE BOSLOOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1420 TUSCULUM BLVD, GREENEVILLE, TN 37745-4279
(423) 787-5000
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2866
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q017697
—
TN
Enumeration date
11/04/2015
Last updated
03/07/2025
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