Individual
JACOB HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6520 W 700 N, SHIPSHEWANA, IN 46565-8505
(260) 350-5018
Mailing address
6520 W 700 N, SHIPSHEWANA, IN 46565-8505
(260) 350-5018
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703112739
MI
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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