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Individual

JEANETTA LEE BOSLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
534 HILLCREST DR, BRANDENBURG, KY 40108-1222
(270) 422-5000
(270) 422-5052
Mailing address
6801 DIXIE HWY, SUITE 130, LOUISVILLE, KY 40258-3913
(270) 422-5000
(270) 422-5052

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25268
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64252687
KY
Enumeration date
12/06/2006
Last updated
08/14/2012
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