Provider Demographics
NPI:1740615152
Name:BOSOMPEM, SABINA (RN)
Entity Type:Individual
Prefix:
First Name:SABINA
Middle Name:
Last Name:BOSOMPEM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIT 28051 BOX 27
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09112-8051
Mailing Address - Country:US
Mailing Address - Phone:315-590-3806
Mailing Address - Fax:
Practice Address - Street 1:SUDLAGER 301
Practice Address - Street 2:
Practice Address - City:VILSECK
Practice Address - State:BAVARIA
Practice Address - Zip Code:92249
Practice Address - Country:DE
Practice Address - Phone:315-590-3806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704257576163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse