Individual
MS. JACQUELINE R HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CNP
Contact information
Practice address
1200 RALSTON AVENUE, DEFIANCE, OH 43512-1396
(419) 783-5655
(419) 866-5453
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN110287
OH
363L00000X
Nurse Practitioner
Primary
COA05242NP
OH
363LF0000X
Family Nurse Practitioner
4704170468
MI
363LF0000X
Family Nurse Practitioner
NP05242
OH
Other
Enumeration date
10/06/2005
Last updated
07/15/2015
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