Individual
KELLY MURIEL HOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3130 E BASELINE RD STE 107, MESA, AZ 85204-7290
(480) 345-1980
(480) 926-1721
Mailing address
1839 S ALMA SCHOOL RD STE 354, MESA, AZ 85210-3028
(480) 726-2287
(888) 503-3312
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
70349500001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
704516001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7046960001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7047150001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7057360001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7209350001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7629170001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7939960001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
8220410001
AZ
363AM0700X
Medical Physician Assistant
Primary
9622
AZ
Other
Enumeration date
06/22/2022
Last updated
07/17/2023
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