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CLYDE RUSSELL BOSWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-BC

Contact information

Practice address
8705 PERIMETER PARK BLVD STE 2, JACKSONVILLE, FL 32216-6353
(904) 248-3910
Mailing address
1102 14TH ST N, JACKSONVILLE BEACH, FL 32250-3662
(615) 830-6176

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
25373
TN
363LF0000X
Family Nurse Practitioner
Primary
APRN11012607
FL

Other

Enumeration date
01/23/2019
Last updated
03/16/2023
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