Individual
STACY LYNN BOGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6601 PHOENIX AVE, SUITE B, FORT SMITH, AR 72903-5092
(479) 785-9091
(479) 782-3415
Mailing address
1 CHILDRENS WAY, SLOT 512-39, LITTLE ROCK, AR 72202-3500
(501) 364-3620
(501) 364-5192
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R88879
AR
Other
Enumeration date
04/18/2012
Last updated
04/18/2012
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