Healthcare Provider Details

I. General information

NPI: 1881815157
Provider Name (Legal Business Name): ANNE E HOGAN MS, PHD, CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W BOISE CIR STE 320
BROKEN ARROW OK
74012-4954
US

IV. Provider business mailing address

1923 S UTICA AVE CREDENTIALING OFC, GROUND FL
TULSA OK
74104-6520
US

V. Phone/Fax

Practice location:
  • Phone: 918-994-9150
  • Fax: 918-403-6323
Mailing address:
  • Phone: 918-403-7065
  • Fax: 918-744-2946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2201001377
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number6320
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number030776
License Number StateOR
# 4
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number6163
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: