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Individual

TONYA LEEANN BOSCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BSN RN PHN

Contact information

Practice address
4038 CONSTELLATION RD, LOMPOC, CA 93436-1413
(724) 713-7414
Mailing address
1301 N A ST, LOMPOC, CA 93436-3516
(805) 742-3301

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN613745
CA

Other

Enumeration date
06/11/2019
Last updated
06/11/2019
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