Provider Demographics
NPI:1194002451
Name:BOGGS, KATHERINE ALLISON (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:ALLISON
Last Name:BOGGS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2666
Mailing Address - Country:US
Mailing Address - Phone:304-253-7550
Mailing Address - Fax:304-253-7552
Practice Address - Street 1:100 N HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2666
Practice Address - Country:US
Practice Address - Phone:304-253-7550
Practice Address - Fax:304-253-7552
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV67347363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily