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Individual

LISA D HOGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1 TAMPA GENERAL CIR, SUITE A327, TAMPA, FL 33606-3571
(813) 844-4396
(813) 844-4972
Mailing address
1 TAMPA GENERAL CIR, SUITE A327, TAMPA, FL 33606-3571
(813) 844-4396
(813) 844-4972

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9178865
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
303984600
FL
01
7705379
AETNA PIN
FL
01
E6257W
MEDICARE GTBA REASSIGN
FL
01
G3402
BCBS
FL
01
P00339881
MEDICARE RAILROAD
FL
Enumeration date
12/08/2005
Last updated
12/09/2010
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