BROOKE BOGGS LLC NPI 1396300562

NPI Information

NPI: 1396300562
Provider Name: BROOKE BOGGS LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
403 LEXINGTON CIR
GRAND ISLAND, NE
ZIP 68803
Phone: (308) 227-6119
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BROOKE BOGGS LLC is a primary care clinic center in Grand Island, NE. BROOKE BOGGS LLC NPI is 1396300562. The provider is registered as an organization entity type.

The provider's business location address is:

403 LEXINGTON CIR
GRAND ISLAND, NE
ZIP 68803-728
Phone: (308) 227-6119
Fax: (308) 888-0018

The provider's authorized official is Brooke Nicole Boggs .
The authorized official title is Owner/provider and has the following contact phone number (308) 530-6569.

The enumeration date for this NPI number is 5/3/2019 and was last updated on 12/10/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	50511752800	MEDICAID	NEBRASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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