Provider Demographics
NPI:1386326643
Name:HOGAN, LINDA A
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:A
Last Name:HOGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5345 BENTLEY DR
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70714-5037
Mailing Address - Country:US
Mailing Address - Phone:225-200-2108
Mailing Address - Fax:
Practice Address - Street 1:5345 BENTLEY DR
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714-5037
Practice Address - Country:US
Practice Address - Phone:225-200-2108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA008469175347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle