Provider Demographics
NPI:1003505850
Name:HOGENSON, JAZMYN RHEA (RN)
Entity Type:Individual
Prefix:
First Name:JAZMYN
Middle Name:RHEA
Last Name:HOGENSON
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 1:402 31ST AVE N APT 208
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-1583
Mailing Address - Country:US
Mailing Address - Phone:701-412-3541
Mailing Address - Fax:
Practice Address - Street 1:402 31ST AVE N APT 208
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-1583
Practice Address - Country:US
Practice Address - Phone:701-412-3541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR54160163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical