Individual
MYIA E BOZEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
29437 HWY 63, STE. 14, LIVINGSTON, LA 70754
(225) 283-1356
(225) 283-1705
Mailing address
PO BOX 395, CLINTON, LA 70722-0395
(225) 683-5292
(225) 683-1310
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
AP09999
LA
363LF0000X
Family Nurse Practitioner
Primary
AP09999
LA
Other
Enumeration date
07/09/2018
Last updated
02/28/2019
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