Provider Demographics
NPI:1184220196
Name:HOGAN, GABRIELA LUCIA (CRNP)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:LUCIA
Last Name:HOGAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:GABRIELA
Other - Middle Name:LUCIA
Other - Last Name:DEPAULO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2100 MACK BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5622
Mailing Address - Country:US
Mailing Address - Phone:484-884-0551
Mailing Address - Fax:
Practice Address - Street 1:1337 BLUE VALLEY DR
Practice Address - Street 2:
Practice Address - City:PEN ARGYL
Practice Address - State:PA
Practice Address - Zip Code:18072-1815
Practice Address - Country:US
Practice Address - Phone:610-654-1270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022729363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily