Priscilla Boateng

Primary specialty

Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X

License

R194705 Issued in MD

Practice address

100 Brewster Blvd
Camp Lejeune, NC 28547-2575

Phone

(910) 450-4270

NPI assigned

Jul 1, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1751328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1790674943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 CROSSROADS STORE DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285460129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472575",
            "telephone_number": "910-450-4270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATENG",
        "first_name": "PRISCILLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-01",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "MD",
            "license": "R194705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mirandah Elise Bletner
• Steve John Blivin, MD
• Karen Kathleen Bloch, ARNP
• Kyle Blood, PA-C
• Daniel Edward Bloom, PHYSICIAN ASSISTANT
• Robert Olliff Boatwright, M.D.
• Joshua Bohac, PA-C
• Emily Bollinger, MD
• Jared Bollinger
• Jillian Wagner Bonaroti, MD

• Gerontology Clinical Nurse Specialist in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Gerontology Clinical Nurse Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.