Individual
KRISTOPHER BOSQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11341 SUNSET HILLS RD, RESTON, VA 20190-5205
(703) 471-0919
Mailing address
21266 VICTORIAS CROSS TER, ASHBURN, VA 20147-4938
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001258580
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024174556
VA
Other
Enumeration date
11/13/2016
Last updated
03/31/2017
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