Organization
BOATOX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA GREEN (REVENUE CYCLE ADMIN)
(903) 571-3844
Entity
Organization
Contact information
Practice address
113 W JACKSON ST STE 1A, RIDGELAND, MS 39157-2401
(601) 863-9663
(855) 343-5763
Mailing address
24898 ROUTE W40, BONAPARTE, IA 52620-8142
(903) 571-3844
(855) 343-5763
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/13/2026
Last updated
01/13/2026
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