Healthcare Provider Details

I. General information

NPI: 1295820892
Provider Name (Legal Business Name): PAMELA A. OGDEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E MICHIGAN AVE SUITE 500
LANSING MI
48912-1899
US

IV. Provider business mailing address

1200 E MICHIGAN AVE SUITE 500
LANSING MI
48912-1899
US

V. Phone/Fax

Practice location:
  • Phone: 517-484-4033
  • Fax: 517-484-2701
Mailing address:
  • Phone: 517-484-4033
  • Fax: 517-484-2701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704152512
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: