Healthcare Provider Details

I. General information

NPI: 1104167402
Provider Name (Legal Business Name): JENNIFER A HOGGARTH CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. JENNIFER A SCHUMANN

II. Dates (important events)

Enumeration Date: 03/12/2013
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 E SWEET AVE
BISMARCK ND
58504-5658
US

IV. Provider business mailing address

200 S 5TH ST
BISMARCK ND
58504-5675
US

V. Phone/Fax

Practice location:
  • Phone: 701-222-4900
  • Fax: 701-222-4999
Mailing address:
  • Phone: 701-222-3937
  • Fax: 701-222-3937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR34013
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: