Individual
MELISSA JEAN BOGGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(443) 854-0691
Mailing address
4883 W UPPER BEND DR, HERRIMAN, UT 84096-2073
(443) 854-0691
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
11014718
FL
Other
Enumeration date
08/09/2021
Last updated
03/07/2022
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