Provider Demographics
NPI:1659346989
Name:HOGLUND, BARBARA A (FNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:HOGLUND
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10081 DOGWOOD ST NW STE 100
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55448-5282
Mailing Address - Country:US
Mailing Address - Phone:763-783-3722
Mailing Address - Fax:763-783-7944
Practice Address - Street 1:10081 DOGWOOD ST NW STE 100
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55448-5282
Practice Address - Country:US
Practice Address - Phone:763-783-3722
Practice Address - Fax:763-783-7944
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1043309363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN021593700Medicaid
MN500001204Medicare ID - Type Unspecified
MN021593700Medicaid