Provider Demographics
NPI:1366610826
Name:HOGAN, TONY LYNN (ARNP)
Entity type:Individual
Prefix:MR
First Name:TONY
Middle Name:LYNN
Last Name:HOGAN
Suffix:
Gender:M
Credentials:ARNP
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Mailing Address - Street 1:100 REYNOLDS RD
Mailing Address - Street 2:STE A
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-1127
Mailing Address - Country:US
Mailing Address - Phone:270-651-6707
Mailing Address - Fax:270-651-1751
Practice Address - Street 1:100 REYNOLDS RD
Practice Address - Street 2:STE A
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-1127
Practice Address - Country:US
Practice Address - Phone:270-651-6707
Practice Address - Fax:270-651-1751
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-18
Last Update Date:2021-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY5287P363L00000X
KY3005287363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner