Eula Faye Boggs
Individual provider Active NPI Nurse's Aide · Laura, OH
NPI 1376687749 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1376687749
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- Practice address
- 10886 Milton Potsdam Rd
Laura, OH 45337-7713 - Phone
- (937) 947-1894
- Fax
- (937) 947-1894
- NPI assigned
- Feb 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | Yes |
Addresses
Primary practice location
10886 Milton Potsdam Rd
Laura, OH 45337-7713
Mailing address
10886 Milton Potsdam Rd
Laura, OH 45337-7713
Phone (937) 947-1894
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2670168 | Medicaid | OH |
Other providers in Laura, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. 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.