Provider Demographics
NPI:1386388437
Name:BOSTIC, CLAIRE (PA-C)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:BOSTIC
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:MARIE
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:165 INDIAN LAKE BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-6216
Mailing Address - Country:US
Mailing Address - Phone:615-637-3131
Mailing Address - Fax:931-208-3616
Practice Address - Street 1:165 INDIAN LAKE BLVD STE 103
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-6216
Practice Address - Country:US
Practice Address - Phone:615-637-3131
Practice Address - Fax:931-208-3616
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6098363A00000X
TXPA15710363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant