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NPI Code Detail

MEDICARE: KELLY LYNN OGG

MEDICARE: KELLY LYNN OGG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical NurseLPN.118778.MEDS-IVOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093982233
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY LYNN OGG
Provider Business Mailing Address
First Line : 6460 HARRISON AVE STE 200
Second Line :
City : CINCINNATI
State : OH
Zip : 45247-7958
Country : US
Telephone Number : 513-941-4999
Fax Number : 513-694-0168
Provider Business Practice Location Address
First Line : 1421 PARKER CT
Second Line :
City : SPRINGFIELD
State : OH
Zip : 45504-2855
Country : US
Telephone Number : 513-941-4999
Fax Number : 513-694-0168
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2008
Last Update Date : 12/11/2024

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