=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386924199
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIA CAROLINE FRENTON-BOGGS LPN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2011
-----------------------------------------------------
Last Update Date | 08/24/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 133 N. PLUM ST.
-----------------------------------------------------
City | GNADENHUTTEN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44629
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-556-8025
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | P.O. BOX 402 133 N. PLUM STREET
-----------------------------------------------------
City | GNADENHUTTEN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44629
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-556-8025
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 164W00000X
-----------------------------------------------------
Taxonomy Name | Licensed Practical Nurse
-----------------------------------------------------
License Number | PN 135747-M-IV
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------