Healthcare Provider Details

I. General information

NPI: 1770728107
Provider Name (Legal Business Name): GABRIEL P HOGUE DNP, FNP-C, ENP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2008
Last Update Date: 10/19/2025
Certification Date: 10/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST NE
ATLANTA GA
30308-2212
US

IV. Provider business mailing address

115 DEVILLA TRCE
FAYETTEVILLE GA
30214-1472
US

V. Phone/Fax

Practice location:
  • Phone: 404-727-7980
  • Fax:
Mailing address:
  • Phone: 616-914-7274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP312314
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: