Provider Demographics
NPI:1205355146
Name:BOGLE, FAITH (FNP-C)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:BOGLE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2946 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37127-8351
Mailing Address - Country:US
Mailing Address - Phone:615-617-6410
Mailing Address - Fax:615-617-6411
Practice Address - Street 1:2946 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37127-8351
Practice Address - Country:US
Practice Address - Phone:615-617-6410
Practice Address - Fax:615-617-6411
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22998363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily