Healthcare Provider Details

I. General information

NPI: 1174741490
Provider Name (Legal Business Name): SANDRA L OGAS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 ROBINSON RD
SEVERNA PARK MD
21146-2899
US

IV. Provider business mailing address

274 LOCUST RIDGE LN
ARNOLD MD
21012-1878
US

V. Phone/Fax

Practice location:
  • Phone: 410-544-0900
  • Fax: 410-544-3088
Mailing address:
  • Phone: 410-544-0900
  • Fax: 410-544-3088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberR038414
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: