Healthcare Provider Details

I. General information

NPI: 1932049095
Provider Name (Legal Business Name): SKYLAR KRISTIN BOGGS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 W UNION ST
ATHENS OH
45701-2732
US

IV. Provider business mailing address

2011 NORTHCREEK DR
ENGLEWOOD OH
45322-2245
US

V. Phone/Fax

Practice location:
  • Phone: 740-593-2500
  • Fax:
Mailing address:
  • Phone: 513-335-7669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: