Provider Demographics
NPI:1508478173
Name:HOGER, DEANNE SUE (MSN, RN CNL)
Entity Type:Individual
Prefix:
First Name:DEANNE
Middle Name:SUE
Last Name:HOGER
Suffix:
Gender:F
Credentials:MSN, RN CNL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4970 REDWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PAULLINA
Mailing Address - State:IA
Mailing Address - Zip Code:51046-7441
Mailing Address - Country:US
Mailing Address - Phone:712-261-0902
Mailing Address - Fax:
Practice Address - Street 1:1200 1ST AVE E
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-4342
Practice Address - Country:US
Practice Address - Phone:712-264-8649
Practice Address - Fax:712-264-8572
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA087272163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse