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General NPI Number Information
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NPI Number | 1134237340
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Entity Type | Individual
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Provider Name | REBECCA WARD HOGSTEN PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 12/04/2020
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Provider Practice Location Address
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Address Line | 4071 TATES CREEK CENTRE DR STE 100
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City | LEXINGTON
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State | KY
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Zip | 40517-3062
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Country | US
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Telephone | 859-273-3888
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Fax |
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Provider Business Mailing Address
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Address Line | 5200 COMMERCE CROSSINGS DR FL 3
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City | LOUISVILLE
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State | KY
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Zip | 40229-2182
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Country | US
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Telephone | 502-253-4900
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Fax | 502-489-5751
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA285
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License Number State | KY
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