Provider Demographics
NPI:1457697187
Name:BOSWELL, KRISTIANA (MA)
Entity Type:Individual
Prefix:
First Name:KRISTIANA
Middle Name:
Last Name:BOSWELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 HAMPTON
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864
Mailing Address - Country:US
Mailing Address - Phone:530-440-1180
Mailing Address - Fax:
Practice Address - Street 1:1133 HAMPTON RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-3841
Practice Address - Country:US
Practice Address - Phone:530-440-1180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic