Provider Demographics
NPI:1932467883
Name:HOGAN, KATHLEEN FARRELL (CNM)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:FARRELL
Last Name:HOGAN
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Gender:F
Credentials:CNM
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Mailing Address - Street 1:6400 ARLINGTON BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-2325
Mailing Address - Country:US
Mailing Address - Phone:703-531-3016
Mailing Address - Fax:703-531-3153
Practice Address - Street 1:6400 ARLINGTON BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-2325
Practice Address - Country:US
Practice Address - Phone:703-531-3016
Practice Address - Fax:703-531-3153
Is Sole Proprietor?:No
Enumeration Date:2012-04-29
Last Update Date:2012-04-29
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Provider Licenses
StateLicense IDTaxonomies
VA0024069457367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife