Provider Demographics
NPI:1104167402
Name:HOGGARTH, JENNIFER A (CRNA)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:A
Last Name:HOGGARTH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:SCHUMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-5675
Mailing Address - Country:US
Mailing Address - Phone:701-222-3937
Mailing Address - Fax:701-222-3937
Practice Address - Street 1:430 E SWEET AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-5658
Practice Address - Country:US
Practice Address - Phone:701-222-4900
Practice Address - Fax:701-222-4999
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR34013367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered