Individual
DUSTIN C BOZWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA/ARNP
Contact information
Practice address
105 E LOCUST ST, BLOOMFIELD, IA 52537-0054
(641) 664-3602
(641) 664-3765
Mailing address
PO BOX 54, BLOOMFIELD, IA 52537-0054
(641) 664-3602
(641) 664-3765
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
14-100965-102
KS
163W00000X
Registered Nurse
2007013208
MO
163W00000X
Registered Nurse
R98156
OK
367500000X
Certified Registered Nurse Anesthetist
Primary
D-111082
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
421417307-V5
UHC/RIVER VALLEY/JD
IA
Enumeration date
05/28/2010
Last updated
02/09/2012
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