Provider Demographics
NPI:1215219308
Name:BOSWORTH, KARI A (ANP)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:A
Last Name:BOSWORTH
Suffix:
Gender:
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23131 GRIST MILL CT
Mailing Address - Street 2:
Mailing Address - City:OLMSTED FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44138-3234
Mailing Address - Country:US
Mailing Address - Phone:440-522-4206
Mailing Address - Fax:
Practice Address - Street 1:7255 OLD OAK BLVD STE C202
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3300
Practice Address - Country:US
Practice Address - Phone:440-816-5390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-12689363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health