MEDICARE: KATHRYN BOGUE FNP-BC

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
1	363L00000X	Nurse Practitioner	11042101	FL

General Provider Information

NPI Number	:	1750248696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN BOGUE FNP-BC

Provider Business Mailing Address
First Line	:	3355 BURNS RD STE 207
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4356
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3355 BURNS RD STE 207
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4356
Country	:	US
Telephone Number	:	561-660-3874
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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