Provider Demographics
NPI:1477591790
Name:BOSWELL, RITA (PA)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:BOSWELL
Suffix:
Gender:F
Credentials:PA
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Other - Last Name:
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Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY
Mailing Address - Street 2:MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-588-9800
Mailing Address - Fax:913-588-9822
Practice Address - Street 1:7405 RENNER RD
Practice Address - Street 2:KU MEDWEST AFTER HOURS / URGENT CARE
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66217-9414
Practice Address - Country:US
Practice Address - Phone:913-588-8450
Practice Address - Fax:913-588-8423
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2008-10-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS15-00275363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200325970AMedicaid
P00272562OtherRR MEDICARE NUMBER
481159444OtherJAYHAWK TAX ID
928284OtherFIRSTGUARD NUMBER
Q44868Medicare UPIN
KSJ61D879AMedicare ID - Type Unspecified