Individual
MELANIE SHANELL BOGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
9800 BROADWAY EXT STE 204, OKLAHOMA CITY, OK 73114-6303
(405) 419-5926
(405) 419-5905
Mailing address
9800 BROADWAY EXT STE 204, OKLAHOMA CITY, OK 73114-6303
(405) 419-5926
(405) 419-5905
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
110497
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851867238
—
OK
Enumeration date
10/23/2018
Last updated
03/24/2020
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