Provider Demographics
NPI:1053069781
Name:OGAR, NSIMA STEPHANIE
Entity Type:Individual
Prefix:
First Name:NSIMA
Middle Name:STEPHANIE
Last Name:OGAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7210 LYNDSEY WAY
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6804
Mailing Address - Country:US
Mailing Address - Phone:240-636-7512
Mailing Address - Fax:
Practice Address - Street 1:7210 LYNDSEY WAY
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6804
Practice Address - Country:US
Practice Address - Phone:240-636-7512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00186476376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide