Provider Demographics
NPI:1013374537
Name:OGLESBY, NATY P (RN)
Entity Type:Individual
Prefix:MS
First Name:NATY
Middle Name:P
Last Name:OGLESBY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 MARCONI AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-5303
Mailing Address - Country:US
Mailing Address - Phone:916-480-1801
Mailing Address - Fax:916-854-2950
Practice Address - Street 1:3737 MARCONI AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-5303
Practice Address - Country:US
Practice Address - Phone:916-480-1801
Practice Address - Fax:916-854-2950
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95039104163WP0809X
CAVN264971164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No164X00000XNursing Service ProvidersLicensed Vocational Nurse