Provider Demographics
NPI:1578399549
Name:HOKANSON, MISTY (ATCT)
Entity type:Individual
Prefix:
First Name:MISTY
Middle Name:
Last Name:HOKANSON
Suffix:
Gender:F
Credentials:ATCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66248 360TH ST
Mailing Address - Street 2:
Mailing Address - City:WATKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55389-6153
Mailing Address - Country:US
Mailing Address - Phone:320-252-1670
Mailing Address - Fax:
Practice Address - Street 1:4801 VETERANS DR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2015
Practice Address - Country:US
Practice Address - Phone:320-252-1670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist