Provider Demographics
NPI:1861479511
Name:HOGG, DOROTHY A (WHCNP)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:A
Last Name:HOGG
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57950 LEAVENWORTH ST
Mailing Address - Street 2:ATTN CREDENITALS OFFICE
Mailing Address - City:MCCONNELL AFB
Mailing Address - State:KS
Mailing Address - Zip Code:67221-3506
Mailing Address - Country:US
Mailing Address - Phone:316-759-5864
Mailing Address - Fax:316-759-5038
Practice Address - Street 1:57950 LEAVENWORTH ST
Practice Address - Street 2:ATTN CREDENITALS OFFICE
Practice Address - City:MCCONNELL AFB
Practice Address - State:KS
Practice Address - Zip Code:67221-3506
Practice Address - Country:US
Practice Address - Phone:316-759-5864
Practice Address - Fax:316-759-5038
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1437982363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health