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Individual

TAMMY MARIE BOGGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
3208 HERSHBERGER RD NW, ROANOKE, VA 24017-1842
(540) 855-0244
(540) 366-5211
Mailing address
1859 HAYMAKERTOWN RD, TROUTVILLE, VA 24175-7074
(540) 202-2397

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002075572
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0002075572
LPN LICENSE
VA
Enumeration date
03/10/2022
Last updated
03/10/2022
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