Provider Demographics
NPI:1760101984
Name:BOSMAN, DARAYNA (LPN)
Entity Type:Individual
Prefix:
First Name:DARAYNA
Middle Name:
Last Name:BOSMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WARREN DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-2848
Mailing Address - Country:US
Mailing Address - Phone:215-626-7591
Mailing Address - Fax:
Practice Address - Street 1:590 NAAMANS RD
Practice Address - Street 2:
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-2308
Practice Address - Country:US
Practice Address - Phone:302-388-9146
Practice Address - Fax:302-442-6575
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN298458164W00000X
DEL2-0024360164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse