Provider Demographics
NPI:1861365264
Name:BOSTON, KAITLIN ANN (BSN, RN)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:ANN
Last Name:BOSTON
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 145TH RD
Mailing Address - Street 2:
Mailing Address - City:ELM CREEK
Mailing Address - State:NE
Mailing Address - Zip Code:68836
Mailing Address - Country:US
Mailing Address - Phone:308-995-3760
Mailing Address - Fax:612-725-1054
Practice Address - Street 1:1118 BURLINGTON ST
Practice Address - Street 2:
Practice Address - City:HOLDREGE
Practice Address - State:NE
Practice Address - Zip Code:68949-1705
Practice Address - Country:US
Practice Address - Phone:308-995-3760
Practice Address - Fax:612-725-1054
Is Sole Proprietor?:No
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE82866163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care