Provider Demographics
NPI:1376840348
Name:HOGG, LEIGH ANN D (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:LEIGH ANN
Middle Name:D
Last Name:HOGG
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MS
Other - First Name:LEIGH ANN
Other - Middle Name:
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RNFA
Mailing Address - Street 1:811 13TH ST
Mailing Address - Street 2:SUITE 20
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2668
Mailing Address - Country:US
Mailing Address - Phone:706-722-3401
Mailing Address - Fax:706-724-6540
Practice Address - Street 1:811 13TH ST
Practice Address - Street 2:SUITE 20
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2668
Practice Address - Country:US
Practice Address - Phone:706-722-3401
Practice Address - Fax:706-724-6540
Is Sole Proprietor?:No
Enumeration Date:2011-02-27
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN134384163WR0006X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant