Individual
MISS SHAUNA L BOSTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNFA
Contact information
Practice address
12 PARK PL STE B, SWANSEA, IL 62226-2923
(618) 233-5722
(618) 233-7069
Mailing address
12 PARK PL STE B, SWANSEA, IL 62226-2923
(618) 233-5722
(618) 233-7069
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
041320642
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041320642
ILLINOIS STATE LICENSE
IL
01
—
2007036610
MISSOURI STATE LICENSE
MO
Enumeration date
10/21/2008
Last updated
10/21/2008
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