Basic Information
| Provider Information | |||||||||
| NPI: | 1518146752 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOGATE | ||||||||
| FirstName: | SHANNON | ||||||||
| MiddleName: | LYNNE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | C.F.N.P | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 PRIDES XING STE 200 | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197136109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3029980300 | ||||||||
| FaxNumber: | 3025438456 | ||||||||
| Practice Location | |||||||||
| Address1: | 1401 FOULK RD STE 205 | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198032764 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3029980300 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2007 | ||||||||
| LastUpdateDate: | 04/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | LG-0000439 | DE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.