Provider Demographics
NPI:1568592582
Name:HOGAN, NORA (APNC)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:HOGAN
Suffix:
Gender:F
Credentials:APNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 E JIMMIE LEEDS RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-4465
Mailing Address - Country:US
Mailing Address - Phone:609-652-6750
Mailing Address - Fax:609-652-2306
Practice Address - Street 1:4 E JIMMIE LEEDS RD
Practice Address - Street 2:SUITE 4
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-4465
Practice Address - Country:US
Practice Address - Phone:609-652-6750
Practice Address - Fax:609-652-2306
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR09755400363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ222969813OtherHORIZON
055406A1ZMedicare ID - Type Unspecified
NJ222969813OtherHORIZON