Provider Demographics
NPI:1073826707
Name:OGBONNA, ANN N (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:N
Last Name:OGBONNA
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3546 FIELDCREST LN
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-6820
Mailing Address - Country:US
Mailing Address - Phone:734-507-1286
Mailing Address - Fax:734-434-8730
Practice Address - Street 1:3546 FIELDCREST LN
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-6820
Practice Address - Country:US
Practice Address - Phone:734-507-1286
Practice Address - Fax:734-434-8730
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704178940163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse