Betty Bossaller, CRNFA
Individual provider Active NPI Registered Nurse First Assistant · Wildwood, MO
NPI 1457525958 · NPPES record last updated Apr 15, 2008
Key facts
- NPI
- 1457525958
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse First Assistant 163WR0006X
- License
- 074540 (MO)
- Practice address
- 2106 Hickory Summit CT
Wildwood, MO 63011-5402 - Phone
- (636) 405-2656
- NPI assigned
- Apr 15, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 074540 | MO | MD | Registered Nurse First Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse First Assistant | 163WR0006X | 074540 | MO | Yes |
Addresses
Primary practice location
2106 Hickory Summit CT
Wildwood, MO 63011-5402
Mailing address
2106 Hickory Summit CT
Wildwood, MO 63011-5402
Phone (636) 405-2656
Other providers in Wildwood, MO
- Rose Marie Bernardez
- Bespoke Physical Therapy, Wellness and Performance
- Abby Leanne Beyer
- Mary K Bland
- Bailee Bonastia
- Heather Marie Boutwell
- Madison Lee Brocato
- Avia Brown
- Kimberly E Brown
- Dean Bryan
All providers in Wildwood, MO · Registered Nurse First Assistant in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.