1891648648 NPI number — PATTY SUE BOGGS CARE COORDINATOR

Table of content: PATTY SUE BOGGS CARE COORDINATOR (NPI 1891648648)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891648648 NPI number — PATTY SUE BOGGS CARE COORDINATOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOGGS
Provider First Name:
PATTY
Provider Middle Name:
SUE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CARE COORDINATOR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MERICA
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
SUE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1891648648
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/19/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
303 THOMPSON RD # 646
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CRAIG
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99921-9800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-254-2904
Provider Business Mailing Address Fax Number:
888-349-6205

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
303 THOMPSON RD # 646
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CRAIG
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99921-9800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-254-2904
Provider Business Practice Location Address Fax Number:
888-349-6205
Provider Enumeration Date:
02/19/2026

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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