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General NPI Number Information
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NPI Number | 1134926132
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Entity Type | Individual
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Provider Name | JESSE HOGLE
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Gender | Male
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 9611 OXFORD AVE
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City | WAVERLY
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State | NE
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Zip | 68462-1643
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Country | US
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Telephone | 303-263-2614
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Fax |
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Provider Business Mailing Address
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Address Line | 220 OAKCREEK DR # NE68528
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City | LINCOLN
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State | NE
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Zip | 68528-1587
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Country | US
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Telephone | 402-817-4959
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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 | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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