Individual
NIKKI T BOZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
118 WESTHAVEN SCHOOL RD, BELLEVILLE, IL 62220-3264
(618) 257-9201
Mailing address
314 CAULFIELD DR, SWANSEA, IL 62226-8915
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
041328367
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041328367
—
IL
Enumeration date
11/13/2017
Last updated
11/13/2017
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