Provider Demographics
NPI:1841891629
Name:BOSSOUS, KATIA STARLENIS
Entity type:Individual
Prefix:
First Name:KATIA
Middle Name:STARLENIS
Last Name:BOSSOUS
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 1:4970 N EXPRESSWAY STE D
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-4269
Mailing Address - Country:US
Mailing Address - Phone:956-802-9553
Mailing Address - Fax:833-313-1449
Practice Address - Street 1:4970 N EXPRESSWAY STE D
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-4269
Practice Address - Country:US
Practice Address - Phone:956-802-9553
Practice Address - Fax:833-313-1449
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT104766163WN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0300XNursing Service ProvidersRegistered NurseNephrology