Provider Demographics
NPI:1194911685
Name:HOGUE, LORI ANNE (APRN)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANNE
Last Name:HOGUE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:LORI
Other - Middle Name:ANNE
Other - Last Name:MAYBERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:450 E. 23RD ST.
Mailing Address - Street 2:FREMONT HEALTH
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025
Mailing Address - Country:US
Mailing Address - Phone:402-721-1610
Mailing Address - Fax:402-727-3677
Practice Address - Street 1:1130 N 204TH AVE
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-1849
Practice Address - Country:US
Practice Address - Phone:402-289-3377
Practice Address - Fax:402-289-5443
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110868363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE110868OtherSTATE LIC