NPI 1710632468

Telisha Boggan, CNA

Practitioner Nurse's Aide Fort Walton Beach, FL

Practice location

Address: 1992 Lewis Turner Blvd STE 1067112, Fort Walton Beach, FL 32547-1255
Phone: (850) 296-2952

Registered specialties

Nurse's Aide Primary

Nursing Service Related Providers Taxonomy 376K00000X Licence CNA200986 (FL)

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Registry record

NPI: 1710632468
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 Feb 2022
Record last updated: 21 Feb 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.