Provider Demographics
NPI:1720725534
Name:HOGANS, NIAMBI RENEE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:NIAMBI
Middle Name:RENEE
Last Name:HOGANS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13401 PENDLETON ST
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5420
Mailing Address - Country:US
Mailing Address - Phone:609-214-7882
Mailing Address - Fax:
Practice Address - Street 1:9009 WOODYARD RD STE 101
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4268
Practice Address - Country:US
Practice Address - Phone:301-877-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR218773363LF0000X
VA0024184269363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily