Individual
MRS. SHANNON HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1101105
KY
363LP0200X
Pediatric Nurse Practitioner
Primary
3006225
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6225P
ARNP
KY
Enumeration date
10/15/2009
Last updated
12/21/2016
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