Provider Demographics
NPI:1902983463
Name:MENKING-HOGGATT, CRISTINA PAULINE (CNM)
Entity Type:Individual
Prefix:MRS
First Name:CRISTINA
Middle Name:PAULINE
Last Name:MENKING-HOGGATT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MRS
Other - First Name:CRISTINA
Other - Middle Name:
Other - Last Name:MENKING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNM
Mailing Address - Street 1:112 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-1518
Mailing Address - Country:US
Mailing Address - Phone:304-345-0033
Mailing Address - Fax:
Practice Address - Street 1:112 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-1518
Practice Address - Country:US
Practice Address - Phone:304-345-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV077367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife