Provider Demographics
NPI:1922456177
Name:HOCEVAR, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:HOCEVAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W1807 ASHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53083-3343
Mailing Address - Country:US
Mailing Address - Phone:920-946-2058
Mailing Address - Fax:
Practice Address - Street 1:W1807 ASHWOOD DR
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53083-3343
Practice Address - Country:US
Practice Address - Phone:920-946-2058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-28
Last Update Date:2016-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI132763163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse