Bogue, Taylor Marie
Bogue, Taylor Marie is an individual health care provider with primary practice located at 2166 Madison Ave , Granite City IL 62040-4700. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Bogue, Taylor Marie can be contacted via phone (618) 452-3301.Contact Information
Primary practice address
2166 Madison Ave
Granite City IL 62040-4700
Phone: (618) 452-3301
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 085006994 | Illinois |
Profile Details
| NPI number | 1043770589 |
|---|---|
| LBN Legal business name | Bogue, Taylor Marie |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 21st, 2019 |
| Last updated | Apr 8th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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