Individual
KATHRYN ANNE BOGART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5838 W BRICK RD STE 106, SOUTH BEND, IN 46628-8420
(574) 247-1911
(574) 247-1912
Mailing address
PO BOX 639295 DEPT 93394, CINCINNATI, OH 45263-9295
(248) 434-6169
(855) 618-6655
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28169267A
IN
363LF0000X
Family Nurse Practitioner
Primary
71003779A
IN
363LP2300X
Primary Care Nurse Practitioner
71003779A
IN
Other
Enumeration date
11/02/2011
Last updated
03/17/2023
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