Healthcare Provider Details

I. General information

NPI: 1184213514
Provider Name (Legal Business Name): JULIE OGDEN BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2021
Last Update Date: 01/11/2021
Certification Date: 01/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2088 TUCKER TRL
LEWIS CENTER OH
43035-8085
US

IV. Provider business mailing address

2088 TUCKER TRL
LEWIS CENTER OH
43035-8085
US

V. Phone/Fax

Practice location:
  • Phone: 614-929-4776
  • Fax:
Mailing address:
  • Phone: 614-929-4776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN259856
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: