Provider Demographics
NPI:1093317729
Name:BOSHEARS, CAITLIND
Entity Type:Individual
Prefix:
First Name:CAITLIND
Middle Name:
Last Name:BOSHEARS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 PRESTON RD APT 923
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8304
Mailing Address - Country:US
Mailing Address - Phone:469-442-8020
Mailing Address - Fax:
Practice Address - Street 1:1520 PRESTON RD APT 923
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8304
Practice Address - Country:US
Practice Address - Phone:469-442-8020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX970814163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse