Provider Demographics
NPI:1902076615
Name:HOGAN, DEBORAH E (APRN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:E
Last Name:HOGAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E HILL AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37915-2566
Mailing Address - Country:US
Mailing Address - Phone:865-862-0998
Mailing Address - Fax:865-544-1861
Practice Address - Street 1:7551 DANNAHER WAY
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-4029
Practice Address - Country:US
Practice Address - Phone:865-637-9330
Practice Address - Fax:865-859-7222
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12670363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN12670OtherLICENSE NUMBER