Healthcare Provider Details

I. General information

NPI: 1578831038
Provider Name (Legal Business Name): NOREEN M OGDEN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2011
Last Update Date: 01/09/2020
Certification Date: 01/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2272 N MAIN ST
CROWN POINT IN
46307-1802
US

IV. Provider business mailing address

824 SUNSET BLVD
SCHERERVILLE IN
46375-2701
US

V. Phone/Fax

Practice location:
  • Phone: 219-661-5601
  • Fax:
Mailing address:
  • Phone: 219-313-5119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71003844A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: