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General NPI Number Information
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NPI Number | 1356942056
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Entity Type | Individual
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Provider Name | CATHERINE MARIE BOGGS NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 11/08/2020
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Last Update Date | 11/11/2021
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Provider Practice Location Address
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Address Line | 720 ESKENAZI AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5187
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Country | US
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Telephone | 317-880-5887
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Fax |
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Provider Business Mailing Address
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Address Line | 2414 ALLENTOWN RD
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City | SELLERSBURG
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State | IN
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Zip | 47172-9713
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Country | US
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Telephone | 317-538-0451
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Fax |
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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 | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 71010534A.
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License Number State | IN
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