Provider Demographics
NPI:1962030908
Name:DEL BOSQUE, JAMIE LEIGH
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEIGH
Last Name:DEL BOSQUE
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 1:6026 SCENIC LINKS
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78108-2378
Mailing Address - Country:US
Mailing Address - Phone:210-602-2290
Mailing Address - Fax:
Practice Address - Street 1:6026 SCENIC LINKS
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78108-2378
Practice Address - Country:US
Practice Address - Phone:210-602-2290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX216071164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse