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General NPI Number Information
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NPI Number | 1710358395
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Entity Type | Individual
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Provider Name | PHILLIP BOGGS AGACNP-BC
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Gender | Male
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Dates
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Enumeration Date | 10/08/2015
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 4755 OGLETOWN STANTON RD STE 2E99
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City | NEWARK
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State | DE
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Zip | 19718-2200
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Country | US
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Telephone | 302-733-5982
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Fax | 302-733-6081
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Provider Business Mailing Address
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Address Line | PO BOX 1088
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City | ARTESIA
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State | CA
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Zip | 90702-1088
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Country | US
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Telephone | 562-869-1070
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Fax | 562-286-8777
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | LP-0010755
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | L1-0073431
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 95003204
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | LP-0010755
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License Number State | DE
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