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Individual

MRS. MARY LEE BOSCHULTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1811 HALLECK PL, COLUMBUS, OH 43209-3222
(614) 732-2481
(614) 236-0632
Mailing address
1811 HALLECK PL, COLUMBUS, OH 43209-3222
(614) 732-2481
(614) 236-0632

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
143576
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NP 01416
NURSE PRACTITIONER
OH
01
R.N. 143576
REGISTERED NURSE LICENSE
OH
Enumeration date
08/29/2006
Last updated
07/08/2007
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