Individual
KIMBERLY HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
13813 METRO PKWY, FORT MYERS, FL 33912-4343
(239) 936-1343
(239) 936-8507
Mailing address
PO BOX 62707, FORT MYERS, FL 33906-2707
(239) 931-3440
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
ARNP3132002
FL
363LG0600X
Gerontology Nurse Practitioner
Primary
ARNP3132002
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016227400
—
FL
01
—
Y0N4V
FLORIDA BLUE
FL
Enumeration date
06/11/2014
Last updated
12/05/2016
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