Healthcare Provider Details

I. General information

NPI: 1700532116
Provider Name (Legal Business Name): ANNA OGREN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2022
Last Update Date: 02/24/2022
Certification Date: 02/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1224 DIVISION ST APT 1
MARQUETTE MI
49855-5108
US

IV. Provider business mailing address

1224 DIVISION ST APT 1
MARQUETTE MI
49855-5108
US

V. Phone/Fax

Practice location:
  • Phone: 906-869-0576
  • Fax:
Mailing address:
  • Phone: 906-869-8816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: