Provider Demographics
NPI:1942792395
Name:HOGAN, CHARMAINE (RN)
Entity type:Individual
Prefix:
First Name:CHARMAINE
Middle Name:
Last Name:HOGAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 LITTLE ELM PKWY STE 1201
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-1921
Mailing Address - Country:US
Mailing Address - Phone:940-440-2923
Mailing Address - Fax:
Practice Address - Street 1:2601 LITTLE ELM PKWY STE 1201
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-1921
Practice Address - Country:US
Practice Address - Phone:409-440-2923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-01
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX842981163WC1600X, 163W00000X
261Q00000X
TX261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care