Doctor Name: | KIMBERLY L. MCQUEEN BOSWELL |
NPI Number: | 1326323700 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | TEMP013255 |
Business Practice Address: | 110 Mordington Avenue Jefferson County Boe Charles Town, WV - 25414 |
Business Phone Number: | 3042673595 |
Business Fax Number: | 3042673599 |
Mailing Address: | 110 Mordington Avenue, Jefferson County Boe CHARLES TOWN |
State: | WV |
Postal Code: | 25414 |
Phone Number: | 3042673595 |
Fax Number: | 3042673599 |
NPI Enumeration Date: | 10/17/2011 |
NPI Last Update Date: | 10/17/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WS0200X |
License Number: | TEMP013255 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | School |
Taxonomy Definition: |