Healthcare Provider Details

I. General information

NPI: 1376716100
Provider Name (Legal Business Name): GINA NICOLE HOEGH LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2008
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 24TH AVE NW
NORMAN OK
73069-6320
US

IV. Provider business mailing address

133 24TH AVE NW
NORMAN OK
73069-6320
US

V. Phone/Fax

Practice location:
  • Phone: 405-928-3008
  • Fax:
Mailing address:
  • Phone: 405-928-3008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number188805
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: