Most Relevant Information
Provider Data
| NPI Number: | 1003289612 |
| Provider Name: | KATIE LYNNE BOSLOOPER PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 2866 |
Most Important Dates
| Enumeration Date: | 11/04/2015 |
| Last Updated: | 02/26/2024 |
Provider Practice Location
1420 TUSCULUM BLVD
GREENEVILLE
TN
377454279
Practice Location Phone/Fax
| Phone: | 4237875000 |
| Fax: |
Provider Mailing Location
1021 W OAKLAND AVE STE 310
JOHNSON CITY
TN
376042192
Provider Mailing Phone/Fax
| Phone: | 4233026565 |
| Fax: |