Provider Demographics
NPI:1689324709
Name:HOGAN-AUTMAN, MO'NIC CHARMEAL
Entity type:Individual
Prefix:MISS
First Name:MO'NIC
Middle Name:CHARMEAL
Last Name:HOGAN-AUTMAN
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 1:4307 KNOLLCROFT RD
Mailing Address - Street 2:
Mailing Address - City:TROTWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45426-1933
Mailing Address - Country:US
Mailing Address - Phone:937-546-8181
Mailing Address - Fax:
Practice Address - Street 1:4307 KNOLLCROFT RD
Practice Address - Street 2:
Practice Address - City:TROTWOOD
Practice Address - State:OH
Practice Address - Zip Code:45426-1933
Practice Address - Country:US
Practice Address - Phone:937-546-8181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
34653246YC3301X
CP2952246YC3302X
0001085246YR1600X
343900000X, 347C00000X, 374U00000X, 376J00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No246YC3301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Hospital Based
No246YC3302XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Physician Office Based
No246YR1600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationRegistered Record Administrator
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker