Provider Demographics
NPI:1639120884
Name:HOGGATT, REBECCA E (PA)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:E
Last Name:HOGGATT
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6100 PAN AMERICAN FWY NE SUITE 390
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109
Mailing Address - Country:US
Mailing Address - Phone:505-823-1805
Mailing Address - Fax:505-823-1844
Practice Address - Street 1:6100 PAN AMERICAN FWY NE SUITE 390
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109
Practice Address - Country:US
Practice Address - Phone:505-823-1805
Practice Address - Fax:505-823-1844
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMNMPA2005-0040363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical