Provider Demographics
NPI:1104516749
Name:BOSCOVICH, JENNIFER (APH, RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BOSCOVICH
Suffix:
Gender:F
Credentials:APH, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9550 S MCCARRAN BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-9211
Mailing Address - Country:US
Mailing Address - Phone:775-813-1651
Mailing Address - Fax:
Practice Address - Street 1:9550 S MCCARRAN BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-9213
Practice Address - Country:US
Practice Address - Phone:775-996-5676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA2013175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath