Provider Demographics
NPI:1164178349
Name:BOSWELL, MEGAN ANN (FNP-C)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANN
Last Name:BOSWELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MANHATTAN SQ STE A
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-6262
Mailing Address - Country:US
Mailing Address - Phone:757-838-6335
Mailing Address - Fax:
Practice Address - Street 1:127 FREEMOOR DR
Practice Address - Street 2:
Practice Address - City:POQUOSON
Practice Address - State:VA
Practice Address - Zip Code:23662-1225
Practice Address - Country:US
Practice Address - Phone:270-559-7258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024183819363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner