Individual
MARIBEL BERENICE BOGGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2651 E DISCOVERY PKWY, BLOOMINGTON, IN 47408-9059
(812) 353-5252
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28281613A
IN
363L00000X
Nurse Practitioner
Primary
71014311A
IN
Other
Enumeration date
06/07/2023
Last updated
10/31/2025
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