Provider Demographics
NPI:1225798465
Name:HOGAN, PEGGY L (RN)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:L
Last Name:HOGAN
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 1:1349 DENNIS ST
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-9064
Mailing Address - Country:US
Mailing Address - Phone:775-771-7824
Mailing Address - Fax:
Practice Address - Street 1:2560 BUSINESS PKWY STE B
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-8961
Practice Address - Country:US
Practice Address - Phone:775-267-9411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV31879163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse