Individual provider Active NPI

Jessica Katherine Bosma, RN, PHN

  • Registered Nurse
  • Pipestone, MN
National Provider Identifier
1831534353
Registry record updated May 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R1752179 Issued in MN
Practice address
1091 N Hiawatha Ave
Pipestone, MN 56164-2286
Phone
(507) 825-5024
Fax
(507) 825-5649
NPI assigned
May 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R1752179 MN Primary

Addresses

Primary practice location

1091 N Hiawatha Ave
Pipestone, MN 56164-2286

Mailing address

1091 N Hiawatha Ave
Pipestone, MN 56164-2286
Phone (507) 825-5024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R1752179MNMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1368144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368144000000",
    "number": "1831534353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1091 N HIAWATHA AVE",
            "city": "PIPESTONE",
            "state": "MN",
            "postal_code": "561642286",
            "telephone_number": "507-825-5024",
            "fax_number": "507-825-5649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1091 N HIAWATHA AVE",
            "city": "PIPESTONE",
            "state": "MN",
            "postal_code": "561642286",
            "telephone_number": "507-825-5024",
            "fax_number": "507-825-5649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSMA",
        "first_name": "JESSICA",
        "middle_name": "KATHERINE",
        "name_prefix": "Mrs.",
        "credential": "RN, PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-10",
        "last_updated": "2013-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R1752179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pipestone, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; 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.