Provider Demographics
NPI:1033556113
Name:BOGGS, BROOKE NICOLE (RN, APRN)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:NICOLE
Last Name:BOGGS
Suffix:
Gender:F
Credentials:RN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 LEXINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-9728
Mailing Address - Country:US
Mailing Address - Phone:308-530-6569
Mailing Address - Fax:308-888-0018
Practice Address - Street 1:403 LEXINGTON CIR
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-9728
Practice Address - Country:US
Practice Address - Phone:308-227-6119
Practice Address - Fax:308-888-0018
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-29
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE64593163WH0200X
NE111996363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WH0200XNursing Service ProvidersRegistered NurseHome Health