Provider Demographics
NPI:1639565328
Name:HOAG, DEBRA A (APRN)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:HOAG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11819 MIRACLE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-5308
Mailing Address - Country:US
Mailing Address - Phone:402-201-2373
Mailing Address - Fax:402-201-2432
Practice Address - Street 1:11819 MIRACLE HILLS DR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-5308
Practice Address - Country:US
Practice Address - Phone:402-201-2373
Practice Address - Fax:402-201-2432
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE111795363L00000X
IAF091641363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health