Provider Demographics
NPI:1326185919
Name:HOGGARD, WANDA MARIE (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:WANDA
Middle Name:MARIE
Last Name:HOGGARD
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 1:3050 REGENT BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-5806
Mailing Address - Country:US
Mailing Address - Phone:757-537-9679
Mailing Address - Fax:
Practice Address - Street 1:1050 W. PERIMETER RD
Practice Address - Street 2:SUITE B5-19 779 MDG
Practice Address - City:ANDREWS AFB
Practice Address - State:MD
Practice Address - Zip Code:20763-6600
Practice Address - Country:US
Practice Address - Phone:757-537-9679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166438363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily