Provider Demographics
NPI:1104459338
Name:HOAGLUND, JANELLE KAY (FPMHNP)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:KAY
Last Name:HOAGLUND
Suffix:
Gender:F
Credentials:FPMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E 20TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-3882
Mailing Address - Country:US
Mailing Address - Phone:307-633-7444
Mailing Address - Fax:
Practice Address - Street 1:800 E 20TH ST STE 300
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3882
Practice Address - Country:US
Practice Address - Phone:307-633-7444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-17
Last Update Date:2023-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO995372363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty