Provider Demographics
NPI:1437192127
Name:BOGGS, LINDA RITA (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:RITA
Last Name:BOGGS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 N US 421 HWY
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-0410
Mailing Address - Country:US
Mailing Address - Phone:910-592-1462
Mailing Address - Fax:
Practice Address - Street 1:906 N US 421 HWY
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-0410
Practice Address - Country:US
Practice Address - Phone:910-592-1462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV00005363AM0700X
NC0010-05055363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical