Provider Demographics
NPI:1043798846
Name:BOEGEL, TONI (LPN)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:BOEGEL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6648 SCATTERGOOD LN
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:WI
Mailing Address - Zip Code:53598-2504
Mailing Address - Country:US
Mailing Address - Phone:608-772-8664
Mailing Address - Fax:
Practice Address - Street 1:6648 SCATTERGOOD LN
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:WI
Practice Address - Zip Code:53598-2504
Practice Address - Country:US
Practice Address - Phone:608-772-8664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI323180164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse