Ellen Rae Bogue, RN
Registered Nurse, Psych/Mental Health in Ukiah, CA. Individual provider (NPI-1).
NPI number1285877175
StatusActive
Last updated in NPPESAug 30, 2013
Details
- NPI
- 1285877175
- Entity type
- Individual (NPI-1)
- Name
- Ms. Ellen Rae Bogue
- Credential
- RN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 8, 2009
- Last updated
- Aug 30, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WP0808X | Registered Nurse, Psych/Mental Health | RN185100 | CA | Yes |
Practice location
270 N Pine StUkiah, CA 95482-4334
Phone 707-972-9040
Mailing address
940 Exley LnWillits, CA 95490-3313
Phone 707-459-2177
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