Provider Demographics
NPI:1407414501
Name:BOSSERT-MCSWIGGAN, JANICE LYNNE ANNE (FNP)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:LYNNE ANNE
Last Name:BOSSERT-MCSWIGGAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 WINDSOR RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4515
Mailing Address - Country:US
Mailing Address - Phone:718-490-7144
Mailing Address - Fax:
Practice Address - Street 1:55 WINDSOR RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-4515
Practice Address - Country:US
Practice Address - Phone:718-490-7144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF-343792-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily