Individual
REGINA C BOGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1301 SIGMAN RD NE STE 180, CONYERS, GA 30012-3924
(678) 609-4913
(678) 609-4293
Mailing address
PO BOX 1508, COVINGTON, GA 30015-1508
(470) 444-1501
(470) 444-1506
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
RN053871
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000762341
—
GA
Enumeration date
04/10/2006
Last updated
02/14/2018
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