Healthcare Provider Details

I. General information

NPI: 1144499914
Provider Name (Legal Business Name): ALICE JOANN OGDEN MSN, APRN-BC,ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 HERRING AVE SUITE 306
WACO TX
76708-3245
US

IV. Provider business mailing address

2911 HERRING AVE SUITE 306
WACO TX
76708-3245
US

V. Phone/Fax

Practice location:
  • Phone: 254-755-4582
  • Fax: 254-755-4585
Mailing address:
  • Phone: 254-755-4582
  • Fax: 254-755-4585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number225777
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: