Individual
JACQUELINE BOSWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
238 STREET RD, APARTMENT C201, SOUTHAMPTON, PA 18966-3172
(215) 364-0500
(215) 942-2578
Mailing address
238 STREET RD, APARTMENT C201, SOUTHAMPTON, PA 18966-3172
(215) 364-0500
(215) 942-2578
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SPO15151
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AG0715011
CERTIFICATION
PA
01
—
SPO15151
LICENSE
PA
Enumeration date
07/27/2015
Last updated
07/27/2015
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