Individual
JESSICA L BOSTATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
2121 HUGHES DR STE 500, TOLEDO, OH 43606-3857
(567) 585-8950
(567) 585-8952
Mailing address
2121 HUGHES DR STE 500, TOLEDO, OH 43606-3857
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN.CNP.16495
OH
363LP0200X
Pediatric Nurse Practitioner
Primary
COA.16495-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0176546
—
OH
Enumeration date
10/20/2014
Last updated
04/01/2026
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