Healthcare Provider Details

I. General information

NPI: 1124426978
Provider Name (Legal Business Name): HELEN HOGGARD APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2014
Last Update Date: 03/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 S UTICA AVE 2ND FLOOR EAST
TULSA OK
74104-4214
US

IV. Provider business mailing address

1245 S UTICA AVE 2ND FLOOR EAST
TULSA OK
74104-4214
US

V. Phone/Fax

Practice location:
  • Phone: 918-382-2567
  • Fax: 918-579-2511
Mailing address:
  • Phone: 918-382-2567
  • Fax: 918-579-2511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number83605
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number83605
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: