Individual provider · NPI-1
Geraldine Bogdan, CNS, NP
Clinical Nurse Specialist, Psych/Mental Health · Portland, ME
NPI number1336218684
StatusActive
Last updated in NPPESDec 16, 2011
Details
- NPI
- 1336218684
- Entity type
- Individual (NPI-1)
- Name
- Geraldine Bogdan
- Credential
- CNS, NP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 8, 2006
- Last updated
- Dec 16, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 364SP0808X | Clinical Nurse Specialist, Psych/Mental Health | R029424 | ME | Yes |
| 363LP0200X | Nurse Practitioner, Pediatrics | R029424 | ME |
Practice location
932 Congress StPortland, ME 04102-3032
Phone 207-662-3005 · Fax 207-662-3863
Mailing address
932 Congress StPortland, ME 04102-3032
Phone 207-662-3005 · Fax 207-662-3863
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