Provider Demographics
NPI:1548743727
Name:HOGG, KATLYN TAYLOR (NP)
Entity Type:Individual
Prefix:
First Name:KATLYN
Middle Name:TAYLOR
Last Name:HOGG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2803 N COLUMBIA ST UNIT D
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-6448
Mailing Address - Country:US
Mailing Address - Phone:478-453-0662
Mailing Address - Fax:478-452-8067
Practice Address - Street 1:2803 N COLUMBIA ST UNIT D
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-6448
Practice Address - Country:US
Practice Address - Phone:478-453-0662
Practice Address - Fax:478-452-8067
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN235966363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner