Most Relevant Information
Provider Data
| NPI Number: | 1003028648 |
| Provider Name: | RAQUEL LYN BOSACKER LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | L0574073 |
Most Important Dates
| Enumeration Date: | 05/04/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
106 NORTH 4TH AVE
FERGUS FALLS
MN
565371034
Practice Location Phone/Fax
| Phone: | 2189983778 |
| Fax: | 2189983187 |
Provider Mailing Location
161 ELM ST
TRACY
MN
561751532
Provider Mailing Phone/Fax
| Phone: | 5076298030 |
| Fax: |