Healthcare Provider Details

I. General information

NPI: 1750665923
Provider Name (Legal Business Name): SCIOBAHN DIANE OGDEN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2011
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 FAIRGROVE CHURCH RD
HICKORY NC
28602-9617
US

IV. Provider business mailing address

PO BOX 840853
DALLAS TX
75284-0426
US

V. Phone/Fax

Practice location:
  • Phone: 828-326-3000
  • Fax:
Mailing address:
  • Phone: 972-233-1999
  • Fax: 972-233-3666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number735339
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP121345
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number7606
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: