Provider Demographics
NPI:1447211768
Name:BOSSIO, MARY L (MSN, CRNP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:L
Last Name:BOSSIO
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3588 FALMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15129-9438
Mailing Address - Country:US
Mailing Address - Phone:724-782-8020
Mailing Address - Fax:
Practice Address - Street 1:VAPHS, UNIVERSITY DRIVE-C
Practice Address - Street 2:112A-U
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240
Practice Address - Country:US
Practice Address - Phone:412-688-6000
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN204271L163W00000X
PAUP006324M363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care