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NPI Code Detail

MEDICARE: MRS. MEGAN Y BOOGAART CFNP

MEDICARE:  MRS. MEGAN Y BOOGAART  CFNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerNP-08628OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000297136OTHERINBC/BS #
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063412435
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MEGAN Y BOOGAART CFNP
Provider Business Mailing Address
First Line : 2369 TRAILARD DR
Second Line :
City : WILLOUGHBY
State : OH
Zip : 44094-9641
Country : US
Telephone Number : 440-527-1412
Fax Number :
Provider Business Practice Location Address
First Line : 7533 CENTER ST
Second Line :
City : MENTOR
State : OH
Zip : 44060-6001
Country : US
Telephone Number : 440-974-8362
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 10/18/2016

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Directions to “ MRS. MEGAN Y BOOGAART CFNP” Practice Location

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