Provider Demographics
NPI:1578026936
Name:BOGANNY, LUKE (CCP)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:BOGANNY
Suffix:
Gender:M
Credentials:CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 MCDOWELL ST STE 300
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2606
Mailing Address - Country:US
Mailing Address - Phone:282-258-1121
Mailing Address - Fax:828-252-6114
Practice Address - Street 1:257 MCDOWELL ST STE 300
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2606
Practice Address - Country:US
Practice Address - Phone:282-258-1121
Practice Address - Fax:828-252-6114
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1000-00592242T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist