Provider Demographics
NPI:1073090437
Name:OGLESBY, LASHONDA (CNA)
Entity Type:Individual
Prefix:MS
First Name:LASHONDA
Middle Name:
Last Name:OGLESBY
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6313 ARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-5423
Mailing Address - Country:US
Mailing Address - Phone:904-444-7436
Mailing Address - Fax:302-347-9830
Practice Address - Street 1:6313 ARLINGTON RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-5423
Practice Address - Country:US
Practice Address - Phone:904-444-7436
Practice Address - Fax:302-347-9830
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X, 310400000X, 372500000X, 372600000X, 376J00000X, 385H00000X
FLCNA254608374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care