Individual
ANN M BOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6401 E WASHINGTON ST, INDIANAPOLIS, IN 46219
(317) 808-7085
(317) 708-0115
Mailing address
PO BOX 746720, ATLANTA, GA 30374-6720
(312) 733-9730
(312) 929-0373
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209013786
IL
363LF0000X
Family Nurse Practitioner
Primary
71005573A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201308690
—
IN
Enumeration date
07/10/2015
Last updated
10/31/2024
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