Healthcare Provider Details

I. General information

NPI: 1801474945
Provider Name (Legal Business Name): DIANA FRANCISCA OGARRO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 03/31/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 WOODMONT LN NW STE 2513
ATLANTA GA
30318-2866
US

IV. Provider business mailing address

1445 WOODMONT LN NW STE 2513
ATLANTA GA
30318-2866
US

V. Phone/Fax

Practice location:
  • Phone: 404-933-5113
  • Fax:
Mailing address:
  • Phone: 404-933-5113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN074402
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: