Provider Demographics
NPI:1922449032
Name:BOSWELL, JAYMI CHRISTINE
Entity Type:Individual
Prefix:
First Name:JAYMI
Middle Name:CHRISTINE
Last Name:BOSWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9303 GILCREASE AVE
Mailing Address - Street 2:UNIT 1231
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-0199
Mailing Address - Country:US
Mailing Address - Phone:580-231-7181
Mailing Address - Fax:
Practice Address - Street 1:9303 GILCREASE AVE
Practice Address - Street 2:UNIT 1231
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-0199
Practice Address - Country:US
Practice Address - Phone:580-231-7181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner