CLYDE RUSSELL BOSWELL FNP-BC NPI 1598229718

NPI Information

NPI: 1598229718
Provider Name: CLYDE RUSSELL BOSWELL, FNP-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: SOLANTIC OF JACKSONVILLE LLC

PECOS Registration: Yes

Address:
8705 PERIMETER PARK BLVD STE 2
JACKSONVILLE, FL
ZIP 32216
Phone: (904) 248-3910
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Clyde Russell Boswell, FNP-BC is a family nurse practitioner in Jacksonville, FL with 6 years of experience. Clyde Russell Boswell, FNP-BC NPI is 1598229718. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8705 PERIMETER PARK BLVD STE 2
JACKSONVILLE, FL
ZIP 32216-353
Phone: (904) 248-3910

The NPI 1598229718 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/23/2019 and was last updated on 8/13/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	25373	TENNESSEE	Yes
2	363LF0000X	Nurse Practitioner	Family	APRN11012607	FLORIDA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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