Provider Demographics
NPI:1851156525
Name:HOGUE, LANCE JR (BSC RN, PMH-BC)
Entity Type:Individual
Prefix:MR
First Name:LANCE
Middle Name:
Last Name:HOGUE
Suffix:JR
Gender:M
Credentials:BSC RN, PMH-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:574E RITCHIE HWY STE 155
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-2925
Mailing Address - Country:US
Mailing Address - Phone:410-269-4046
Mailing Address - Fax:
Practice Address - Street 1:574E RITCHIE HWY STE 155
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-2925
Practice Address - Country:US
Practice Address - Phone:410-269-4046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR110272163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health