Provider Demographics
NPI:1548552912
Name:HOGAN, ANNE E (ANP)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:E
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:SYRACUSE UNIVERSITY HEALTH
Mailing Address - Street 2:111 WAVERLY AVE
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13244-0001
Mailing Address - Country:US
Mailing Address - Phone:315-443-2666
Mailing Address - Fax:315-443-9010
Practice Address - Street 1:SYRACUSE UNIVERSITY HEALTH
Practice Address - Street 2:111 WAVERLY AVE
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13244-0001
Practice Address - Country:US
Practice Address - Phone:315-443-2666
Practice Address - Fax:315-443-9010
Is Sole Proprietor?:No
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY363LA220X 300797363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health