Provider Demographics
NPI:1326253808
Name:HOGAN, VIRGINIA S (RN, CNP)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:S
Last Name:HOGAN
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8235 SANTA MONICA BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-5969
Mailing Address - Country:US
Mailing Address - Phone:859-512-4400
Mailing Address - Fax:
Practice Address - Street 1:1421 S POTOMAC ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4535
Practice Address - Country:US
Practice Address - Phone:859-512-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2024-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005142363LP0808X, 363LF0000X
CA23439363LP0808X
NYF403014363LP0808X
TXAP143004363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily