Provider Demographics
NPI:1669986840
Name:BOGDANOVIC, NANCY (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:BOGDANOVIC
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 WOODS ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-4873
Mailing Address - Country:US
Mailing Address - Phone:310-987-0862
Mailing Address - Fax:
Practice Address - Street 1:3421 W DAVIS ST STE 150
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-1848
Practice Address - Country:US
Practice Address - Phone:936-339-2373
Practice Address - Fax:936-249-0318
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-26
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA600435163W00000X, 163WA2000X, 163WC1500X, 163WH1000X
251G00000X
CA95008020363LA2100X, 363LA2200X, 363LC1500X, 363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No251G00000XAgenciesHospice Care, Community Based
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care