National Provider Identifier Database

KELLY D BOGGS, CNP – NPI #1366109498
Gerontology


Contact Information

KELLY D BOGGS, CNP
10506 MONTGOMERY RD STE 301A
MONTGOMERY, OH45242-4400
Phone: 513-246-2400
Fax: 513-246-4050
Website:
Specialty Taxonomy Code
* Gerontology 363LG0600X
Acute Care 363LA2100X

* Indicates primary specialty

NPI Profile & details for KELLY D BOGGS

NPI Number 1366109498
Credentials CNP (Certified Nurse Practitioner)
Entity Individual
Enumeration date 11/23/2021
Last updated 04/26/2023 - About 3 years ago
Sole proprietor1 No
Identifiers
  • OH License #: APRN.CNP.0030319
  • OH License #: CNP.0030319
  • OH Medicaid: 0462231
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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