Provider Demographics
NPI:1477211712
Name:PATEL, BOSKI N (FNP-BC)
Entity Type:Individual
Prefix:
First Name:BOSKI
Middle Name:N
Last Name:PATEL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 746652
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6652
Mailing Address - Country:US
Mailing Address - Phone:904-720-0599
Mailing Address - Fax:904-376-4036
Practice Address - Street 1:1747 BAPTIST CLAY DR STE 320
Practice Address - Street 2:
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-8503
Practice Address - Country:US
Practice Address - Phone:904-224-5185
Practice Address - Fax:904-278-7284
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016750363LF0000X, 363L00000X
IL209.024529363LF0000X
FL11016750363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily