Provider Demographics
NPI:1184760159
Name:BOGUS, DONNA MONTGOMERY (CRNP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MONTGOMERY
Last Name:BOGUS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:421 WEST COLLEGE ST
Mailing Address - Street 2:421 WEST COLLEGE ST
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630
Mailing Address - Country:US
Mailing Address - Phone:256-760-0670
Mailing Address - Fax:256-764-1139
Practice Address - Street 1:1 HOSPITAL DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6455
Practice Address - Country:US
Practice Address - Phone:256-429-4000
Practice Address - Fax:256-325-6724
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1058433363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics