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Individual

MRS. STACIE MARIE HOGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BSN, IBCLC

Contact information

Practice address
3142 BRAMBLETON AVE, ROANOKE, VA 24018-3727
(540) 200-8662
Mailing address
5416 SETTER RD, ROANOKE, VA 24012-8548
(540) 915-8400

Taxonomy

Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-309398
VA
163WL0100X
Lactation Consultant (Registered Nurse)
L-309498
VA

Other

Enumeration date
02/22/2023
Last updated
02/22/2023
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