Provider Demographics
NPI:1033801840
Name:BOSSIER, ANGELA (LPN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:BOSSIER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1145
Mailing Address - Street 2:
Mailing Address - City:SCOTT
Mailing Address - State:LA
Mailing Address - Zip Code:70583-1145
Mailing Address - Country:US
Mailing Address - Phone:337-255-2480
Mailing Address - Fax:
Practice Address - Street 1:5520 JOHNSTON ST # K635
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-5138
Practice Address - Country:US
Practice Address - Phone:337-255-2480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA20150080164W00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No164W00000XNursing Service ProvidersLicensed Practical Nurse