Provider Demographics
NPI:1861829830
Name:BOGGESS, REBECCA L (APRN)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:L
Last Name:BOGGESS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:220 BURLEY AVE
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-8725
Mailing Address - Country:US
Mailing Address - Phone:270-885-6428
Mailing Address - Fax:270-885-4901
Practice Address - Street 1:220 BURLEY AVE
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-8725
Practice Address - Country:US
Practice Address - Phone:270-885-6428
Practice Address - Fax:270-885-4901
Is Sole Proprietor?:No
Enumeration Date:2013-10-04
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3008299363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care