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Individual

MARSHA BOSSEAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Taxonomy

Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
041411812
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041.411812
STATE OF ILLINOIS
IL
01
041411812
STATES OF ILL
IL
Enumeration date
12/21/2022
Last updated
12/21/2022
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