Provider Demographics
NPI:1326646951
Name:HOGUE, TRUDY L
Entity Type:Individual
Prefix:
First Name:TRUDY
Middle Name:L
Last Name:HOGUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 GIBBONS DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:ND
Mailing Address - Zip Code:58504-9167
Mailing Address - Country:US
Mailing Address - Phone:701-527-0473
Mailing Address - Fax:
Practice Address - Street 1:12 GIBBONS DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:ND
Practice Address - Zip Code:58504-9167
Practice Address - Country:US
Practice Address - Phone:701-527-0473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant