Provider Demographics
NPI:1033670278
Name:BOZEMAN, ASHANTI (RN)
Entity Type:Individual
Prefix:
First Name:ASHANTI
Middle Name:
Last Name:BOZEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38603 FALKIRK DR
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-5842
Mailing Address - Country:US
Mailing Address - Phone:214-258-3995
Mailing Address - Fax:
Practice Address - Street 1:38603 FALKIRK DR
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-5842
Practice Address - Country:US
Practice Address - Phone:214-258-3995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-29
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX890602163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse