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General NPI Number Information
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NPI Number | 1184391088
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Entity Type | Individual
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Provider Name | JACLYN NICOLE BOGGS NP
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Gender | Female
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Dates
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Enumeration Date | 08/27/2021
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Last Update Date | 08/16/2026
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Provider Practice Location Address
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Address Line | 11714 197TH ST # 2
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City | SAINT ALBANS
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State | NY
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Zip | 11412-3454
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Country | US
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Telephone | 772-267-0331
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Fax |
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Provider Business Mailing Address
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Address Line | 11714 197TH ST
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City | SAINT ALBANS
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State | NY
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Zip | 11412-3454
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Country | US
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Telephone | 612-568-3843
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Fax | 915-277-3221
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 348277
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2681020
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | LG-0013731
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License Number State | DE
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704441979APP26
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 204604
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License Number State | ND
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | A193176
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License Number State | IA
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Taxonomy #7
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 53-85627-081
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License Number State | KS
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Taxonomy #8
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11045668
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License Number State | FL
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Taxonomy #9
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.1001762-NP
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License Number State | CO
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Taxonomy #10
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | CNP261398
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License Number State | ME
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Taxonomy #11
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 12.018059
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License Number State | CT
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Taxonomy #12
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN-287365
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License Number State | MT
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Taxonomy #13
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209.035226
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License Number State | IL
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Taxonomy #14
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN-6027
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License Number State | HI
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Taxonomy #15
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN-RNP337884
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License Number State | AZ
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