Healthcare Provider Details

I. General information

NPI: 1164866745
Provider Name (Legal Business Name): KAREN DENISE OGARD L.P.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2013
Last Update Date: 04/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2775 E LANSING DR
EAST LANSING MI
48823-7755
US

IV. Provider business mailing address

834 WILLIAMS ST
WILLIAMSTON MI
48895-1228
US

V. Phone/Fax

Practice location:
  • Phone: 517-332-1616
  • Fax:
Mailing address:
  • Phone: 517-281-8209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number4703095494
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: