MEDICARE: ABIGAIL OGLE NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	5007299	NC

General Provider Information

NPI Number	:	1154726248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL OGLE NP

Provider Business Mailing Address
First Line	:	1523 E BROWNING AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-6412
Country	:	US
Telephone Number	:	901-496-0717
Fax Number	:

Provider Business Practice Location Address
First Line	:	7206 N MILBURN AVE STE 105
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-8450
Country	:	US
Telephone Number	:	559-224-5003
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2014
Last Update Date	:	08/28/2020

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