MEDICARE: MICHELLE HOGAN NP WELLNESS CONSULTANT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1164364741
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHELLE HOGAN NP WELLNESS CONSULTANT LLC

Provider Business Mailing Address
First Line	:	89 9TH ST
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-7422
Country	:	US
Telephone Number	:	239-777-5541
Fax Number	:

Provider Business Practice Location Address
First Line	:	89 9TH ST
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-7422
Country	:	US
Telephone Number	:	239-777-5541
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MICHELLE HOGAN
Credential	:	APRN, FNP-BC, NP-C
Telephone Number	:	239-777-5541

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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