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Individual

CHRISTY DAWN BOSWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
100 S. BLISS AVENUE, TAHLEQUAH, OK 74464
(918) 458-3100
Mailing address
1387W 4TH ST, TAHLEQUAH, OK 74464-9766
(918) 453-5554
(918) 431-4112

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
77908
OK

Other

Enumeration date
08/29/2012
Last updated
12/02/2015
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