Provider Demographics
NPI:1699450643
Name:GLOBAL-ACCESS HEALTH AND WELLNESS PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:GLOBAL-ACCESS HEALTH AND WELLNESS PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSTIC
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:678-839-9268
Mailing Address - Street 1:2112 BRUMMEL ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3608
Mailing Address - Country:US
Mailing Address - Phone:678-839-9268
Mailing Address - Fax:
Practice Address - Street 1:122 S MICHIGAN AVE STE 1390-J59
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-6191
Practice Address - Country:US
Practice Address - Phone:773-352-1360
Practice Address - Fax:773-352-1361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-19
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty