Provider Demographics
NPI:1922357920
Name:BOGDANSKI, JAQI HERSEY (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JAQI
Middle Name:HERSEY
Last Name:BOGDANSKI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 IRON WORKS WAY
Mailing Address - Street 2:
Mailing Address - City:SAUGUS
Mailing Address - State:MA
Mailing Address - Zip Code:01906-1490
Mailing Address - Country:US
Mailing Address - Phone:781-290-9902
Mailing Address - Fax:
Practice Address - Street 1:47 NEWBURY ST UNIT 7
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-3867
Practice Address - Country:US
Practice Address - Phone:978-278-5414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2270729163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse