Basic Information
Provider Information
NPI: 1285878777
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOGUE
FirstName: RITA
MiddleName: RAE
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 400 E 10TH ST
Address2:  
City: WACONIA
State: MN
PostalCode: 553874552
CountryCode: US
TelephoneNumber: 9524429770
FaxNumber: 9524423621
Practice Location
Address1: 801 5TH ST
Address2:  
City: SIOUX CITY
State: IA
PostalCode: 511011326
CountryCode: US
TelephoneNumber: 7122792505
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/28/2009
LastUpdateDate: 04/28/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X089374IAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


Home