Individual
MS. STEPHANIE ELLEN BOOSAHDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
654 WILLOW ST, BASS RIVER, SOUTH YARMOUTH, MA 02664-5636
(508) 360-6227
Mailing address
654 WILLOW ST, BASS RIVER, SOUTH YARMOUTH, MA 02664-5636
(508) 360-6227
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN57523
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPN57523
MASSACHUSETTS BOARD OF NURSING
MA
Enumeration date
03/31/2017
Last updated
03/31/2017
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