Individual
MS. DEANDRIA MARIE BOGART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
101OKOLONA DRIVE, ERWIN, TN 37650
(423) 743-9103
(423) 743-9105
Mailing address
101OKOLONA DRIVE, ERWIN, TN 37650
(423) 743-9103
(423) 743-9105
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
RN0000100171
TN
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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