Individual
MRS. MALLORY RAE HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4520 W 69TH ST, SIOUX FALLS, SD 57108-8148
(605) 977-5000
(605) 977-5377
Mailing address
8805 W 18TH ST, SIOUX FALLS, SD 57106-7596
(056) 941-1240
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CP001457
SD
Other
Enumeration date
09/26/2018
Last updated
04/04/2024
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