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NPI Profile for GARY B BOGGS in MCCOMB, MS.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Acute Care |
363LA2100X | 50 | Nurse Practitioner |
| NPI # | 1194219584 |
|
| Status | Active | |
| Credentials | AGACNP | |
| Entity | Individual | |
| Enumeration date | 06/19/2018 | |
| Last updated | 09/20/2022 - About 4 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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GARY B BOGGS
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GARY B BOGGS, AGACNP