Individual
ERIN ANN BOSTICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3466 PINE RIDGE RD STE A, NAPLES, FL 34109-3883
(239) 261-2663
(239) 626-5633
Mailing address
3466 PINE RIDGE RD, STE A, NAPLES, FL 34109-3883
(239) 261-2663
(239) 262-5633
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9109309
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9109309
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
061834800
—
FL
01
—
C697F
BCBS
FL
01
—
IM891Z
MEDICARE
FL
Enumeration date
11/11/2015
Last updated
08/12/2019
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