Provider Demographics
NPI:1831154038
Name:HOGAN, NANCY LYNN (CNP)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:LYNN
Last Name:HOGAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7185 DAYTON SPRINGFIELD RD
Mailing Address - Street 2:
Mailing Address - City:ENON
Mailing Address - State:OH
Mailing Address - Zip Code:45323-1467
Mailing Address - Country:US
Mailing Address - Phone:937-863-0083
Mailing Address - Fax:937-863-0272
Practice Address - Street 1:7185 DAYTON SPRINGFIELD RD
Practice Address - Street 2:
Practice Address - City:ENON
Practice Address - State:OH
Practice Address - Zip Code:45323-1467
Practice Address - Country:US
Practice Address - Phone:937-863-0083
Practice Address - Fax:937-863-0272
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.05741363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2263750Medicaid
OH0996294Medicaid
OHP43576Medicare UPIN