STACEY MARIE BOSWELL


Address: 2003 Stults Rd, Suite 120, Huntington, IN 46750-1291
Phone: 2604540425

STACEY MARIE BOSWELL (NPI# 1114268125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1114268125
Entity Type Individual
Full Name STACEY MARIE BOSWELL
Other Name STACEY MARIE SUDHOFF
Credential PA
Practice Address 2003 Stults Rd
Suite 120
Huntington
IN 46750-1291
Mailing Address 3702 New Vision Dr
Bldg B
Fort Wayne
IN 46845-1703
Practice Telephone 2604540425
Practice Fax Number 2603550299
Mailing Telephone 2602668210
Mailing Fax Number 2604585636
Enumeration Date 2013-03-15
Last Update Date 2018-03-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant 10001506A IN Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 2003 STULTS RD
SUITE 120
City HUNTINGTON
State IN
Zip Code 46750-1291

Providers in the same location

NPI Name Taxonomy Address Enumeration
1437158839 Julie A Utendorf Family Medicine 2003 Stults Rd, Suite 100, Huntington, IN 46750-1291 2005-07-18
1720458664 Jami Metzger Nurse Practitioner 2003 Stults Rd, Suite 100, Huntington, IN 46750-1291 2015-10-05
1992109391 Megan Bobay Dietitian, Registered 2003 Stults Rd, Suite 105, Huntington, IN 46750-1291 2014-10-14
1902114655 C. Bryan Wait, M.d., Internal Medicine, P.C. Internal Medicine 2003 Stults Rd, John B. Kay Mob, Suite 110, Huntington, IN 46750-1291 2010-09-15
1265558829 Family Practice Associates, LLP Clinic/Center 2003 Stults Rd, Suite 100, Huntington, IN 46750-1291 2007-03-22
1871669473 Parkview Health System, Inc. Durable Medical Equipment & Medical Supplies 2003 Stults Rd, Suite 215, Huntington, IN 46750-1291 2006-11-27
1154401230 Vickie Jean Gayed Nurse Practitioner 2003 Stults Rd, Suite 100, Huntington, IN 46750-1291 2006-10-16
1932134590 Kevin R. Stamm Obstetrics & Gynecology 2003 Stults Rd, Suite 120, Huntington, IN 46750-1291 2006-07-12
1649259607 Orthopaedics Northeast, PC Durable Medical Equipment & Medical Supplies 2003 Stults Rd, Suite 210, Huntington, IN 46750-1291 2006-01-10
1598758500 Heather L Smith Physician Assistant 2003 Stults Rd, #210, Huntington, IN 46750-1291 2005-08-24
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1457750457 Michael Sands Physical Therapist 2001 Stults Road, Huntington, IN 46750 2014-08-15
1487917894 Chelsi Huff Speech-Language Pathologist 1401 Park Hill Dr, Huntington, IN 46750 2012-06-20
1346540556 Timothy Theye Social Worker 2860 Norhpark Ave., Huntington, IN 46750 2010-10-22
1710215090 Manry Optometry, Inc. Optometrist 2932 Wal-mart Dr, Huntington, IN 46750 2009-11-25
1821114372 Assisted Living Concepts Inc Assisted Living Facility 460 Forks of The Waba, Huntington, IN 46750 2007-03-22
1740316199 Christine A Schnitz Day Training/Habilitation Specialist 435 Campus, Kids Kampus, Huntington, IN 46750 2007-02-27
1447397450 Pathfinder Services Inc Occupational Therapist 435 Campus St, Huntington, IN 46750 2007-01-31
1487703781 Sally Eileen Herman Social Worker 552 N Jefferson, Huntington, IN 46750 2007-01-09
1841356482 Womens Medical Specialists Obstetrics & Gynecology 1060 Etna Avenue, Huntington, IN 46750 2006-12-28
1386748531 Thomas J Ringenberg Family Medicine 941 Etna Ave, Huntington, IN 46750 2006-09-09
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1780294520 Emily Lisanti Physician Assistant 17 Grandview St, Huntington, NY 11743-3534 2020-08-06
1194342667 Alexandra J Fitts Physician Assistant 9 Sherman St, Huntington, NY 11743-6241 2020-07-01
1851850762 Adam Phillip Otworth Physician Assistant 2900 1st Ave Rm 228, Huntington, WV 25702-1241 2019-03-19
1376001628 Elise Frances Lacarrubba Physician Assistant 5 E Huxley Dr, Huntington, NY 11743-1009 2019-03-06
1770980534 Emily Ann Sombke Physician Assistant 249 Manor Rd., Huntington, NY 11743 2014-11-21
1477800977 Patrick Shannon Lee Physician Assistant Attn: Tammie Silva, 1340 Hal Greer Boulevard, Huntington, WV 25701-3800 2012-08-14
1134430184 Jennifer Louise Hofmann Physician Assistant 15 Greenhill Ln, Huntington, NY 11743-5818 2010-06-24
1356581466 Anna M Kowalczyk Physician Assistant 24 Bartlett Pl, Huntington, NY 11743-3702 2009-03-02
1952520496 Carol Schachter Physician Assistant 180 East Pulaski Road, Huntington, NY 11746 2007-04-24
1598856536 Kimberly A Bastible Physician Assistant 18 Harmony Rd, Huntington, NY 11743-2316 2006-09-27
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City HUNTINGTON
Zip Code 46750

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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