Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 300345 | NC |
NPI | 1013079938 |
---|---|
Provider Name | Mrs. Susan T Hoggard |
First Address | Ahoskie, NC 27910-3207 |
Second Address | Ahoskie, NC 27910-3207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 08/07/2007 |