Provider Demographics
NPI:1265522973
Name:BOSCHEE, AVA KAY (APRN)
Entity type:Individual
Prefix:MS
First Name:AVA
Middle Name:KAY
Last Name:BOSCHEE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 DICKINSON ST
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-4714
Mailing Address - Country:US
Mailing Address - Phone:406-234-6577
Mailing Address - Fax:406-234-5785
Practice Address - Street 1:210 S WINCHESTER AVE
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-4742
Practice Address - Country:US
Practice Address - Phone:406-874-5600
Practice Address - Fax:406-874-5696
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10052363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health