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Individual

MS. STEPHANIE ANN BOSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
15519 CRENSHAW BLVD, GARDENA, CA 90249-4525
(310) 679-9126
Mailing address
15519 CRENSHAW BLVD, GARDENA, CA 90249-4525
(310) 679-9126

Taxonomy

Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
550157
CA
163WD1100X
Peritoneal Dialysis Registered Nurse
550157
CA

Other

Enumeration date
09/08/2016
Last updated
01/04/2022
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