Provider Demographics
NPI:1124474358
Name:HOGG-DUNCAN, BRANDY (NP)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:HOGG-DUNCAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3645 E MAIN ST
Mailing Address - Street 2:#270
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-5934
Mailing Address - Country:US
Mailing Address - Phone:765-983-3410
Mailing Address - Fax:765-983-3045
Practice Address - Street 1:1050 REID PKWY
Practice Address - Street 2:SUITE # 240
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1155
Practice Address - Country:US
Practice Address - Phone:765-983-3410
Practice Address - Fax:765-983-3045
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28169890A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner