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General NPI Number Information
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NPI Number | 1477939825
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Entity Type | Individual
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Provider Name | KIMBERLY N BOGAR APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/08/2015
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Last Update Date | 10/09/2018
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Provider Practice Location Address
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Address Line | 1609 W 3RD AVE
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City | WILLIAMSON
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State | WV
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Zip | 25661-3006
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Country | US
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Telephone | 304-235-0026
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Fax | 304-235-0028
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Provider Business Mailing Address
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Address Line | 1609 W 3RD AVE
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City | WILLIAMSON
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State | WV
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Zip | 25661-3006
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Country | US
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Telephone | 304-235-0026
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Fax | 304-235-0028
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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 | 3009592
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License Number State | KY
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