Individual
BRENDA BOSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1612 5TH AVE, FORT WORTH, TX 76104-4324
(817) 759-9255
Mailing address
7133 QUAIL RIDGE RD, FORT WORTH, TX 76132-3529
(214) 799-9783
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP102860
TX
Other
Enumeration date
12/02/2013
Last updated
10/21/2024
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