Provider Demographics
NPI:1326444845
Name:BOSCH, LOAN (FNP-C)
Entity Type:Individual
Prefix:
First Name:LOAN
Middle Name:
Last Name:BOSCH
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 1:20525 AMBERFIELD DR UNIT 104
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-4381
Mailing Address - Country:US
Mailing Address - Phone:866-335-9311
Mailing Address - Fax:
Practice Address - Street 1:20525 AMBERFIELD DR UNIT 104
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-4381
Practice Address - Country:US
Practice Address - Phone:866-335-9311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-11
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9302658363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily