Provider Demographics
NPI:1073241543
Name:OGLESBY, LARAIN H (STNA)
Entity Type:Individual
Prefix:
First Name:LARAIN
Middle Name:H
Last Name:OGLESBY
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 COUNTRY LN APT 505
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5848
Mailing Address - Country:US
Mailing Address - Phone:440-318-9550
Mailing Address - Fax:
Practice Address - Street 1:4800 COUNTRY LN APT 505
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5848
Practice Address - Country:US
Practice Address - Phone:440-318-9550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401444590912376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty