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NPI Code Detail

MEDICARE: JESSICA RENEE BOGART

MEDICARE:   JESSICA RENEE BOGART
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
1163WC0200XCritical Care Medicine Registered NurseRN.1644219CO
2363L00000XNurse Practitioner0999854CO

General Provider Information

NPI Number : 1891549341
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA RENEE BOGART
Provider Business Mailing Address
First Line : 20789 E PRINCETON PL
Second Line :
City : AURORA
State : CO
Zip : 80013-6057
Country : US
Telephone Number : 719-680-2666
Fax Number :
Provider Business Practice Location Address
First Line : 20789 E PRINCETON PL
Second Line :
City : AURORA
State : CO
Zip : 80013-6057
Country : US
Telephone Number : 719-680-2666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2024
Last Update Date : 06/26/2024

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Directions to “ JESSICA RENEE BOGART ” Practice Location

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