Individual
MRS. MEGAN JEAN BOOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3173 43RD ST S STE A, FARGO, ND 58104-4564
(701) 478-8780
(701) 478-8781
Mailing address
3173 43RD ST S STE A, FARGO, ND 58104-4564
(701) 478-8780
(701) 478-8781
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
25MP00226200
NJ
363A00000X
Physician Assistant
Primary
PAC0844
ND
Other
Enumeration date
10/01/2009
Last updated
08/18/2020
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