Provider Demographics
NPI:1093460651
Name:HOGUE, ABBY LYNN (PA)
Entity Type:Individual
Prefix:MRS
First Name:ABBY
Middle Name:LYNN
Last Name:HOGUE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8690 KRUPP RD
Mailing Address - Street 2:
Mailing Address - City:BELDING
Mailing Address - State:MI
Mailing Address - Zip Code:48809-9530
Mailing Address - Country:US
Mailing Address - Phone:616-914-7183
Mailing Address - Fax:
Practice Address - Street 1:8690 KRUPP RD
Practice Address - Street 2:
Practice Address - City:BELDING
Practice Address - State:MI
Practice Address - Zip Code:48809-9530
Practice Address - Country:US
Practice Address - Phone:616-914-7183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-12
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601010955363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant