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Individual

ROXIE MAE HOGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
2298 YOUNG AVE, MEMPHIS, TN 38104-5755
(731) 207-4496
(731) 201-5273
Mailing address
20A THOMAS HOGAN RD, ALLIGATOR, MS 38720-0401
(662) 902-1299

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
205119
LA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
29238
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
903125
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
95014733
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
HOGA-RG7658
PMHNP-BC
MS
Enumeration date
03/20/2019
Last updated
07/01/2024
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