Provider Demographics
NPI:1740632033
Name:BOSWELL-DAVIES, STEPHANIE (MIDWIFE)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:BOSWELL-DAVIES
Suffix:
Gender:F
Credentials:MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 STONE ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-3250
Mailing Address - Country:US
Mailing Address - Phone:315-788-8065
Mailing Address - Fax:315-222-7432
Practice Address - Street 1:160 STONE ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-3250
Practice Address - Country:US
Practice Address - Phone:315-788-8065
Practice Address - Fax:315-222-7432
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001728176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife