Healthcare Provider Details

I. General information

NPI: 1205357084
Provider Name (Legal Business Name): ALISON WOGATSKE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2017
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1562 OPOSSUMTOWN PIKE
FREDERICK MD
21702-4920
US

IV. Provider business mailing address

1 FREDERICK HEALTH WAY
FREDERICK MD
21701-7097
US

V. Phone/Fax

Practice location:
  • Phone: 240-215-6310
  • Fax: 240-566-7754
Mailing address:
  • Phone: 240-215-6310
  • Fax: 240-566-7754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR200199
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: