Provider Demographics
NPI:1679359335
Name:HOGUE, LYNDSEY SHIRELLE (NP)
Entity Type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:SHIRELLE
Last Name:HOGUE
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 1:27845 NANTICOKE RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-1646
Mailing Address - Country:US
Mailing Address - Phone:979-450-1421
Mailing Address - Fax:
Practice Address - Street 1:1340 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-4590
Practice Address - Country:US
Practice Address - Phone:443-978-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR256029363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner