Individual
KENNETH L BOSWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
990 OAK RIDGE TPKE, OAK RIDGE, TN 37830-6976
(865) 481-1112
(770) 237-1124
Mailing address
PO BOX 5059, OAK RIDGE, TN 37831-5059
(800) 611-6713
(770) 237-1124
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
152347
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152347
NURSING LICENSE
TN
Enumeration date
03/16/2006
Last updated
12/06/2010
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