Provider Demographics
NPI:1316426893
Name:BOSSE, STEPHANIE LYNNE (FNP)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LYNNE
Last Name:BOSSE
Suffix:
Gender:F
Credentials:FNP
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Mailing Address - Street 1:43 WHITING HILL RD STE 300
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1006
Mailing Address - Country:US
Mailing Address - Phone:207-947-6141
Mailing Address - Fax:207-941-5699
Practice Address - Street 1:33 WHITING HILL RD STE 300
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1021
Practice Address - Country:US
Practice Address - Phone:207-973-7478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2019-12-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MECNP181194207R00000X, 364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine