Individual provider · Type 1 NPI
Mallory Elizabeth Boggs, A-GNP-C
Primary Care Nurse Practitioner · Madison, MS
NPI number
1013543388
Active
Practice location
159 Fountains Blvd Ste B
Madison, MS 39110-6344
Mailing address
115 Blackstone Cir
Brandon, MS 39047-8808
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | 903821 (MS) |
Primary Care Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1013543388
Mallory Elizabeth Boggs, A-GNP-C's National Provider Identifier is 1013543388, issued on Mar 19, 2020. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Madison, MS. The record was last updated on Mar 19, 2020.