Provider Demographics
NPI:1235903030
Name:BOGGS, BETH ANGEL
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ANGEL
Last Name:BOGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4331 PALOMINO RD NW
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:OH
Mailing Address - Zip Code:43783-9654
Mailing Address - Country:US
Mailing Address - Phone:740-407-8164
Mailing Address - Fax:
Practice Address - Street 1:4331 PALOMINO RD NW
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:OH
Practice Address - Zip Code:43783-9654
Practice Address - Country:US
Practice Address - Phone:740-407-8164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide