Healthcare Provider Details

I. General information

NPI: 1871958009
Provider Name (Legal Business Name): TIFFANY OGDEN APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2015
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 SW 30TH CT STE A
MOORE OK
73160-2887
US

IV. Provider business mailing address

3116 CASTLE CREEK DR
NEWCASTLE OK
73065-6141
US

V. Phone/Fax

Practice location:
  • Phone: 405-703-0937
  • Fax: 888-290-8567
Mailing address:
  • Phone: 405-408-6080
  • Fax: 888-678-8616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95895
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: