Individual
MR. VINCENT BERNARD BOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN-CRNA
Contact information
Practice address
9501 FARRELL RD, DEWITT ARMY COMMUNITY HOSPITAL, FORT BELVOIR, VA 22060-5901
(703) 805-0342
(703) 805-0731
Mailing address
8402 SEGO LILY CT, LORTON, VA 22079
(703) 919-7859
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024164349
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174569263
—
VA
Enumeration date
06/20/2006
Last updated
01/25/2011
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