Provider Demographics
NPI:1780063750
Name:HOGUE, NANCY (LPN)
Entity type:Individual
Prefix:MRS
First Name:NANCY
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 1:3962 VISTA PARK
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-4422
Mailing Address - Country:US
Mailing Address - Phone:231-590-1710
Mailing Address - Fax:
Practice Address - Street 1:3962 VISTA PARK
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-4422
Practice Address - Country:US
Practice Address - Phone:231-590-1710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-24
Last Update Date:2015-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703057313164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse