Healthcare Provider Details

I. General information

NPI: 1831819879
Provider Name (Legal Business Name): KEISHA A HOGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 K ST NW APT 406
WASHINGTON DC
20001-3346
US

IV. Provider business mailing address

1517 TUBMAN RD SE
WASHINGTON DC
20020-2959
US

V. Phone/Fax

Practice location:
  • Phone: 202-971-2551
  • Fax:
Mailing address:
  • Phone: 202-749-3503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200006928
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: