Healthcare Provider Details

I. General information

NPI: 1093279630
Provider Name (Legal Business Name): EMILY ELIZABETH OGDEN APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2019
Last Update Date: 05/19/2022
Certification Date: 06/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 E CLARK BASS BLVD
MCALESTER OK
74501-4209
US

IV. Provider business mailing address

1 E CLARK BASS BLVD
MCALESTER OK
74501-4209
US

V. Phone/Fax

Practice location:
  • Phone: 918-426-1800
  • Fax:
Mailing address:
  • Phone: 918-426-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR0087892
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR0087892
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: