Individual
AMBER IMANI HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
861 HEALTH PARK BLVD, GRAND BLANC, MI 48439-7383
(810) 953-0500
(810) 953-0031
Mailing address
861 HEALTH PARK BLVD, GRAND BLANC, MI 48439-7383
(810) 953-0500
(810) 953-0031
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13262
PA LICENSE
MN
01
—
5601009493
PA LICENSE
MI
Enumeration date
11/25/2019
Last updated
03/07/2023
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