Individual
MARCIA G BOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,MSN, FNP
Contact information
Practice address
8075 N SHADELAND AVE, INDIANAPOLIS, IN 46250-2693
(317) 621-8500
Mailing address
8840 COMMERCE PARK PL STE E, INDIANAPOLIS, IN 46268-3129
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001727A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200507600
—
IN
Enumeration date
03/28/2008
Last updated
06/17/2021
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