| Doctor Name: | MARCIA G BOGUE |
| NPI Number: | 1396917571 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN,MSN, FNP |
| License Number: | 71001727A |
| Business Practice Address: | 712 W Main St Greentown, IN - 469361045 |
| Business Phone Number: | 7656283317 |
| Business Fax Number: | 7656285979 |
| Mailing Address: | 10330 N Meridian St, Suite 201 INDIANAPOLIS |
| State: | IN |
| Postal Code: | 462901024 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/28/2008 |
| NPI Last Update Date: | 03/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 71001727A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |