GAIL P BOSCO (NPI# 1538205380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538205380 |
| Entity Type | Individual |
| Full Name | GAIL P BOSCO |
| Credential | PA |
| Practice Address |
2430 E Mason St Green Bay WI 54302-3759 |
| Practice Telephone | 9204069863 |
| Mailing Telephone | 9204069863 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2014-04-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2092 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 41935400 | 05 | |
| WI | LICENSE | 2092 | 01 |
| Street Address |
2430 E MASON ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54302-3759 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962452052 | Shopko Stores Operating Company | Optometrist | 2430 E Mason St, Green Bay, WI 54302-3759 | 2006-05-11 |
| 1629408745 | John Simonet | Pharmacist | 2430 E Mason St, Green Bay, WI 54302-3759 | 2013-11-26 |
| 1154768547 | Susan Gilson | Pharmacist | 2430 E Mason St, Green Bay, WI 54302-3759 | 2013-05-27 |
| 1013351287 | Lynn Marie Bond | Pharmacist | 2430 E Mason St, Green Bay, WI 54302-3759 | 2013-04-18 |
| 1144574286 | Christine A Thomas | Pharmacist | 2430 E Mason St, Green Bay, WI 54302-3759 | 2012-10-27 |
| 1578750766 | John Richard Hofmann | Pharmacist | 2430 E Mason St, Green Bay, WI 54302-3759 | 2007-10-01 |
| 1881797462 | Josephine M Mcintosh | Nurse Practitioner | 2430 E Mason St, Green Bay, WI 54302-3759 | 2006-09-07 |
| 1316049943 | Jennifer Ann Lenius | Physician Assistant | 2430 E Mason St, Green Bay, WI 54302-3759 | 2006-09-03 |
| 1609896042 | James L Schmonsky IIi | Optometrist | 2430 E Mason St, Green Bay, WI 54302-3759 | 2006-07-20 |
| 1003862442 | Shopko Stores Operating Co LLC | Pharmacy | 2430 E Mason St, Green Bay, WI 54302-3759 | 2006-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659721371 | Carissa Marie Sawicki | Counselor | 1234 Main Street, Suite 21, 3rd Floor, Green Bay, WI 54302 | 2016-06-14 |
| 1891181459 | Shannon Rae Mullins | Registered Nurse | 2254 Imperial Ln, Green Bay, WI 54302 | 2015-04-10 |
| 1346667045 | David Howard Jadin | Dentist | 1245 Main St, Green Bay, WI 54302 | 2014-03-20 |
| 1407003577 | Abby Baumgart | Counselor | 1234-21 Main St, Green Bay, WI 54302 | 2008-08-20 |
| 1447441779 | Muller Eyecare Associates Ltd | Optometrist | 1776 E Mason St, Green Bay, WI 54302 | 2007-08-01 |
| 1851385231 | Bornemann Nursing Home Inc | Skilled Nursing Facility | 226 Bornemann St, Green Bay, WI 54302 | 2005-08-31 |
| 1194188706 | Familia Dental Green Bay LLC | Dentist | 1931 Main St., Green Bay, WI 54302 | 2016-03-31 |
| 1255710125 | Kim Lawrence | Social Worker | 1234 Main St., St 21, 3rd Floor, Green Bay, WI 54302 | 2015-05-26 |
| 1255464533 | John Muller | Optometrist | 1776 E Mason St, Green Bay, WI 54302 | 2007-03-14 |
| 1851622005 | Michael Andrew Larkey | Social Worker | 815 Reber St, Green Bay, WI 54302-1116 | 2010-01-27 |
| Find all providers in zip 54302 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003476276 | Jenna Mae Hanson | Physician Assistant | 1715 Dousman St, Green Bay, WI 54303-3211 | 2019-06-19 |
| 1275049140 | Miranda Mary Cseter | Physician Assistant | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2017-12-14 |
| 1437506110 | Jessica Zarzecki | Physician Assistant | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2016-05-23 |
| 1205219680 | Mitchell J Lind | Physician Assistant | 1630 Commanche Ave, Green Bay, WI 54313-5753 | 2015-07-03 |
| 1164614327 | Kristin M Mccabe | Physician Assistant | 744 S Webster Ave, 2nd Floor, Green Bay, WI 54301-3505 | 2007-08-13 |
| 1609826171 | Jacquelyn Renee Phillips | Physician Assistant | 744 S Webster Ave, 2nd Floor, Green Bay, WI 54301-3505 | 2006-05-12 |
| 1801898564 | William Robert Conrad | Physician Assistant | 720 S Van Buren St, Suite 301, Green Bay, WI 54301-3538 | 2005-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093348542 | Christopher Sean Lanctin | Physician Assistant | 557 N 17th St Apt 310, Milwaukee, WI 53233-2128 | 2020-02-12 |
| 1750936068 | Javier Eugenio Font | Physician Assistant | 813 N Clover Ln, Cottage Grove, WI 53527-9433 | 2019-08-04 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1588225544 | Hannah Elizabeth Krum | Physician Assistant | S80w17784 Brennan Dr, Muskego, WI 53150-8828 | 2019-06-21 |
| 1255825162 | Katelyn Marie Frankwick | Physician Assistant | 1011 E Spruce St # 6, Abbotsford, WI 54405-9647 | 2018-06-15 |
| 1831644228 | Megan E Nelson | Physician Assistant | 221 E Mills Dr, Lake Mills, WI 53551-1910 | 2016-08-16 |
| 1356717904 | Amy Hermus | Physician Assistant | 451 Butternut Dr, Oregon, WI 53575-1349 | 2015-08-18 |
| 1497168066 | Alexander J Hill | Physician Assistant | 1111 North Road, Mauston, WI 53948-0700 | 2014-06-11 |
| 1487083242 | Andrew John Miller | Physician Assistant | 1521 Lakeview Ave, Wausau, WI 54401-6168 | 2013-11-02 |
| 1386944502 | Bethany Rose Yard | Physician Assistant | 18601 Lincoln Street, Whitehall, WI 54773 | 2010-10-22 |
| Find all providers with the same taxonomy | ||||
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| 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.