Provider Demographics
NPI:1336546688
Name:HOGUE, BROOKE (LPN)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:HOGUE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1644 CANTEBURY LN
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-8678
Mailing Address - Country:US
Mailing Address - Phone:513-313-1542
Mailing Address - Fax:
Practice Address - Street 1:8050 HOSBROOK RD
Practice Address - Street 2:#406
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2994
Practice Address - Country:US
Practice Address - Phone:513-984-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-02
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.140839-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse