Provider Demographics
NPI:1548416753
Name:FOGLE, JOANN (RN)
Entity Type:Individual
Prefix:MS
First Name:JOANN
Middle Name:
Last Name:FOGLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JO ANN
Other - Middle Name:
Other - Last Name:MCCRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1207 BLANTON PLACE
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092
Mailing Address - Country:US
Mailing Address - Phone:903-816-0040
Mailing Address - Fax:
Practice Address - Street 1:1207 BLANTON PL
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-5309
Practice Address - Country:US
Practice Address - Phone:903-816-0040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX509695163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management