Organization
BROOKE BOGGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE NICOLE BOGGS APRN (OWNER/PROVIDER)
(308) 530-6569
Entity
Organization
Contact information
Practice address
403 LEXINGTON CIR, GRAND ISLAND, NE 68803-9728
(308) 227-6119
(308) 888-0018
Mailing address
403 LEXINGTON CIR, GRAND ISLAND, NE 68803-9728
(308) 227-6119
(308) 888-0018
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50511752800
—
NE
Enumeration date
05/03/2019
Last updated
12/10/2020
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