Provider Demographics
NPI:1245976851
Name:BOGGS, ANNETTE (RN)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:BOGGS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4432 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-3311
Mailing Address - Country:US
Mailing Address - Phone:724-732-6175
Mailing Address - Fax:
Practice Address - Street 1:235 MICHAEL DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:PA
Practice Address - Zip Code:16116-2115
Practice Address - Country:US
Practice Address - Phone:724-965-8355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN331510L163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health