Provider Demographics
NPI:1023727047
Name:BOGGS, JAMIE LEE (CNP-AGAC-BC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEE
Last Name:BOGGS
Suffix:
Gender:F
Credentials:CNP-AGAC-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 E GALBRAITH RD STE 215
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-6706
Mailing Address - Country:US
Mailing Address - Phone:513-421-3494
Mailing Address - Fax:513-345-2606
Practice Address - Street 1:4750 E GALBRAITH RD STE 215
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-6706
Practice Address - Country:US
Practice Address - Phone:513-421-3494
Practice Address - Fax:513-345-2606
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2024-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH358121363LA2100X
OHAPRN.CNP.0032833363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care