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General NPI Number Information
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NPI Number | 1073003059
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Entity Type | Individual
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Provider Name | KATIE ROSE VOGAN NP
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Gender | Female
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Dates
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Enumeration Date | 05/15/2018
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Last Update Date | 03/19/2020
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Provider Practice Location Address
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Address Line | 2375 E CAMELBACK RD STE 600
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City | PHOENIX
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State | AZ
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Zip | 85016-3493
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Country | US
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Telephone | 602-387-4035
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Fax |
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Provider Business Mailing Address
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Address Line | 6265 E ORION ST
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City | MESA
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State | AZ
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Zip | 85215-9750
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Country | US
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Telephone | 254-423-1699
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | RN191834
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP11423
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License Number State | AZ
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