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Individual

ILLENA Y BOGGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, FNP-BC

Contact information

Practice address
6572 MIDLAND TRAIL RD, ASHLAND, KY 41102-9286
(606) 928-7755
(606) 928-0052
Mailing address
6572 MIDLAND TRAIL RD, ASHLAND, KY 41102-9286
(606) 928-7755
(606) 928-0052

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
3010111
KY
363LF0000X
Family Nurse Practitioner
Primary
APRN-50349
WV

Other

Enumeration date
02/26/2016
Last updated
01/06/2017
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