Provider Demographics
NPI:1447282082
Name:HOGAN, CARRIE L (ANP)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:L
Last Name:HOGAN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 SNYDERS LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WYNANTSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12198
Mailing Address - Country:US
Mailing Address - Phone:518-326-5277
Mailing Address - Fax:
Practice Address - Street 1:515 LOUDON RD
Practice Address - Street 2:SIENA COLLEGE HEALTH SERVICE
Practice Address - City:LOUDONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12211-1459
Practice Address - Country:US
Practice Address - Phone:518-783-2554
Practice Address - Fax:518-783-2961
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302334-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health