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General NPI Number Information
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NPI Number | 1790137354
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Entity Type | Individual
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Provider Name | BENJAMIN DAVID BOGLE DNP, APNP, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 07/07/2016
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 3004 GOLF RD STE 100
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City | EAU CLAIRE
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State | WI
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Zip | 54701-8794
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Country | US
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Telephone | 715-514-2827
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Fax | 888-606-1323
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Provider Business Mailing Address
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Address Line | 3004 GOLF RD STE 103
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City | EAU CLAIRE
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State | WI
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Zip | 54701-8794
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Country | US
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Telephone | 715-514-2827
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Fax | 888-606-1323
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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 | 8591
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 7045-33
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License Number State | WI
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