Provider Demographics
NPI:1952431942
Name:BOGGS, ELIZABETH A (CNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:BOGGS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:BANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:5900 PARKWOOD PLACE STE 100
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-1266
Mailing Address - Country:US
Mailing Address - Phone:419-564-8999
Mailing Address - Fax:614-794-4500
Practice Address - Street 1:5900 PARKWOOD PLACE STE 100
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-1266
Practice Address - Country:US
Practice Address - Phone:419-564-8999
Practice Address - Fax:614-794-4500
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN265872COA1363LA2200X
OH09122363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2793142Medicaid
OHH086682Medicare PIN