Individual
JEFFREY E BOSANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
929 N SAINT FRANCIS ST, WICHITA, KS 67214-3821
(800) 374-5326
(800) 374-7656
Mailing address
PO BOX 2897, WICHITA, KS 67201-2897
(800) 374-5326
(800) 374-7656
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1390042011
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
55620
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078310
AANA
—
01
—
145988
BCBS OF KS
KS
05
—
200508480A
—
KS
01
—
P00606333
RR MEDICARE GROUP CQ2302
KS
Enumeration date
08/27/2007
Last updated
08/08/2008
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