Healthcare Provider Details

I. General information

NPI: 1053724799
Provider Name (Legal Business Name): PATRICIA HOGAN APN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2014
Last Update Date: 12/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1921 NEW RD.
NORTHFIELD NJ
08225
US

IV. Provider business mailing address

2445 S. DELSEA DR
VINELAND NJ
08360
US

V. Phone/Fax

Practice location:
  • Phone: 609-677-9499
  • Fax:
Mailing address:
  • Phone: 856-418-5433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ00442800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number26NJ00442800
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number26NJ00442800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: