Individual
KAYLA GRACE BOSCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2819 DENNY AVE, PASCAGOULA, MS 39581-5301
(228) 762-3466
Mailing address
4205 BENTZ CT, PASCAGOULA, MS 39581-2306
(228) 627-8345
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904312
MS
Other
Enumeration date
12/09/2020
Last updated
05/02/2022
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