Provider Demographics
NPI:1194553545
Name:BOGDAN, ANABEL MARIE (RN)
Entity type:Individual
Prefix:MRS
First Name:ANABEL
Middle Name:MARIE
Last Name:BOGDAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11311 E URSULA AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-6561
Mailing Address - Country:US
Mailing Address - Phone:847-312-5154
Mailing Address - Fax:
Practice Address - Street 1:8045 E PORTOBELLO AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-1690
Practice Address - Country:US
Practice Address - Phone:480-507-1404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ238101163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool