Mrs Russell Roy Boersma, LPN is a
Licensed Vocational Nurse based in Fort Belvoir, Virginia. Mrs Russell Roy Boersma is licensed to practice in California (license number 159452) and his current practice location is
9501 Farrell Rd, Fort Belvoir, Virginia. He can be reached at his office (for appointments etc.) via phone at
(703) 805-0599.
NPI number for Mrs Russell Roy Boersma is 1245221217 and his current mailing address is 48 Tavern Rd, Stafford, Virginia. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1245221217.
Provider's Profile
| Full Name | Mrs Russell Roy Boersma |
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| Gender | Male |
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| Speciality | Licensed Vocational Nurse |
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| Location | 9501 Farrell Rd, Fort Belvoir, Virginia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1245221217
- Provider Enumeration Date: 10/31/2005
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mrs Russell Roy Boersma such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245221217 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164X00000X | Licensed Vocational Nurse | 159452 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Russell Roy Boersma is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Russell Roy Boersma, LPN
48 Tavern Rd,
Stafford, VA 22554-8814
Ph: (540) 657-8750 | Mrs Russell Roy Boersma, LPN
9501 Farrell Rd,
Fort Belvoir, VA 22060-5901
Ph: (703) 805-0599 |
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