Individual
AMANDA CLIFFORD BOGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
483 E COUNTY LINE RD, HATBORO, PA 19040-1204
(610) 873-5437
(484) 879-6395
Mailing address
483 E COUNTY LINE ROAD, HATBORO, PA 19040
(215) 441-5670
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP012286
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1034912730003
—
PA
Enumeration date
10/01/2012
Last updated
07/23/2021
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