Provider Demographics
NPI:1255777181
Name:HOAG, ABBIE ANN (ABBIE HOAG)
Entity type:Individual
Prefix:
First Name:ABBIE
Middle Name:ANN
Last Name:HOAG
Suffix:
Gender:F
Credentials:ABBIE HOAG
Other - Prefix:
Other - First Name:ABBIE
Other - Middle Name:ANN
Other - Last Name:HOAG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RNC, CPN, IBCLC
Mailing Address - Street 1:562 REGENCY CIR
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-4627
Mailing Address - Country:US
Mailing Address - Phone:707-446-8959
Mailing Address - Fax:707-359-4339
Practice Address - Street 1:562 REGENCY CIR
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4627
Practice Address - Country:US
Practice Address - Phone:707-446-8959
Practice Address - Fax:707-359-4339
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-19
Last Update Date:2013-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA409438163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant