Individual
JORDAN BOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23251 W MOLINE MARTIN RD, MILLBURY, OH 43447-9522
(419) 265-1813
Mailing address
23251 W MOLINE MARTIN RD, MILLBURY, OH 43447-9522
(419) 265-1813
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
432068
OH
367500000X
Certified Registered Nurse Anesthetist
0020600
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
143781
OH
Other
Enumeration date
06/08/2022
Last updated
08/31/2022
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