Provider Demographics
NPI:1477052306
Name:BOZUNG, CHRISTINE MARIE
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:MARIE
Last Name:BOZUNG
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 1:2780 WOODLAKE RD SW APT 2
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-4640
Mailing Address - Country:US
Mailing Address - Phone:206-963-6880
Mailing Address - Fax:
Practice Address - Street 1:2780 WOODLAKE RD SW APT 2
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519-4640
Practice Address - Country:US
Practice Address - Phone:206-963-6880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-06
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant