Estella Ann Boger, GNP-C
Individual provider Active NPI Gerontology Nurse Practitioner · Grand Forks, ND
NPI 1003833435 · NPPES record last updated Jul 31, 2012
Key facts
- NPI
- 1003833435
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- R25076 (ND)
- Practice address
- 1000 S Columbia Rd
Grand Forks, ND 58201-4032 - Phone
- (701) 780-5000
- NPI assigned
- Jul 15, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R25076 | ND | MD | Gerontology Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | R25076 | ND | Yes |
Addresses
Primary practice location
1000 S Columbia Rd
Grand Forks, ND 58201-4032
Mailing address
1212 Cherry St
Grand Forks, ND 58201-5549
Phone (701) 238-9443
Other providers in Grand Forks, ND
- Jamie J Boe
- Chad E Boen
- Kari Elizabeth Boese
- Terra L Boettcher
- Jodi R Boettner
- Ashlei Bogert
- Kayla Mae Bolden
- Julie Anne Bolduc
- Megan Elizabeth Bolek
- Lindsey Bolin
All providers in Grand Forks, ND · Gerontology Nurse Practitioner in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.