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NPI Code Detail

MEDICARE: MR. JAMES MICHAEL HOGLE JR. RN, BSN, MSW, MS-NP

MEDICARE: MR. JAMES MICHAEL HOGLE JR. RN, BSN, MSW, MS-NP
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
11041C0700XClinical Social Worker6801069202MI
2163WP0808XPsychiatric/Mental Health Registered Nurse4704280816MI
3363LP0808XPsychiatric/Mental Health Nurse Practitioner4704280816MI

General Provider Information

NPI Number : 1760710164
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES MICHAEL HOGLE JR. RN, BSN, MSW, MS-NP
Provider Business Mailing Address
First Line : PO BOX 746723
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6723
Country : US
Telephone Number : 312-733-9730
Fax Number :
Provider Business Practice Location Address
First Line : 11260 E JEFFERSON AVE
Second Line :
City : DETROIT
State : MI
Zip : 48214-3320
Country : US
Telephone Number : 313-749-0148
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2009
Last Update Date : 09/02/2021

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