Healthcare Provider Details

I. General information

NPI: 1730093683
Provider Name (Legal Business Name): PAULINE OGUERI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5665 PEACHTREE DUNWOODY RD
SANDY SPRINGS GA
30342-1764
US

IV. Provider business mailing address

7751 BELFORT PKWY STE 120
JACKSONVILLE FL
32256-6921
US

V. Phone/Fax

Practice location:
  • Phone: 940-372-3943
  • Fax:
Mailing address:
  • Phone: 904-372-3943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-NP250785
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: