Healthcare Provider Details

I. General information

NPI: 1801282116
Provider Name (Legal Business Name): KIMBERLY ANN OGLESBY-MCCOWAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY ANN OGLESBY-MCCOWAN FNP

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 OUTLET CENTER DR
OXNARD CA
93036-0663
US

IV. Provider business mailing address

4240 HARBOUR ISLAND LANE
OXNARD CA
93035
US

V. Phone/Fax

Practice location:
  • Phone: 805-981-8300
  • Fax: 805-981-8302
Mailing address:
  • Phone: 805-797-3599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95002183
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: