Provider Demographics
NPI:1891255303
Name:BOGGS, DIANA (CNP)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:BOGGS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:RENE
Other - Last Name:SAUNDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6005 WOODBEND DR
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-2858
Mailing Address - Country:US
Mailing Address - Phone:225-301-6335
Mailing Address - Fax:
Practice Address - Street 1:500 RUE DE LA VIE ST STE 400
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-5128
Practice Address - Country:US
Practice Address - Phone:225-215-7430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200079363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily