Provider Demographics
NPI:1366230351
Name:BOSWELL, ANNA GABRIELA (RDN, LDN)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:GABRIELA
Last Name:BOSWELL
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 N 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-4531
Mailing Address - Country:US
Mailing Address - Phone:210-863-0039
Mailing Address - Fax:
Practice Address - Street 1:1921 N 8TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-4531
Practice Address - Country:US
Practice Address - Phone:210-863-0039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND9619133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered