Provider Demographics
NPI:1790084176
Name:BOSHONEK, NIKOLE LYN (MSN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:NIKOLE
Middle Name:LYN
Last Name:BOSHONEK
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43604 EMERALD DUNES PL
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-3967
Mailing Address - Country:US
Mailing Address - Phone:757-619-4846
Mailing Address - Fax:
Practice Address - Street 1:43604 EMERALD DUNES PL
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3967
Practice Address - Country:US
Practice Address - Phone:757-619-4846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169311363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily