Healthcare Provider Details

I. General information

NPI: 1003751694
Provider Name (Legal Business Name): MARY ANN HOAGLUND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5322 N 52ND ST
OMAHA NE
68104-2279
US

IV. Provider business mailing address

5322 N 52ND ST
OMAHA NE
68104-2279
US

V. Phone/Fax

Practice location:
  • Phone: 531-299-1861
  • Fax:
Mailing address:
  • Phone: 531-299-1861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number40182
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: