Provider Demographics
NPI:1144929480
Name:NOGOY, MARVIN (APRN)
Entity type:Individual
Prefix:
First Name:MARVIN
Middle Name:
Last Name:NOGOY
Suffix:
Gender:M
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:PO BOX 5013
Mailing Address - Street 2:
Mailing Address - City:HAGATNA
Mailing Address - State:GU
Mailing Address - Zip Code:96932-8657
Mailing Address - Country:US
Mailing Address - Phone:671-482-4410
Mailing Address - Fax:
Practice Address - Street 1:633 GOV CARLOS G CAMACHO RD STE 210
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3195
Practice Address - Country:US
Practice Address - Phone:671-649-1001
Practice Address - Fax:671-649-1002
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209025976363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily