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Individual
TAMMY MARIE BOGGS
Active
Individual
TAMMY MARIE BOGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002075572
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002075572
LPN LICENSE
VA
Enumeration date
03/10/2022
Last updated
03/10/2022
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