Provider Demographics
NPI:1265861439
Name:OGLESBY, LEVINCHI C (APRN, AGPCNP-BC)
Entity Type:Individual
Prefix:MR
First Name:LEVINCHI
Middle Name:C
Last Name:OGLESBY
Suffix:
Gender:M
Credentials:APRN, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3217 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-3759
Mailing Address - Country:US
Mailing Address - Phone:912-267-0058
Mailing Address - Fax:912-267-0061
Practice Address - Street 1:3217 4TH ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-3759
Practice Address - Country:US
Practice Address - Phone:912-267-0058
Practice Address - Fax:912-267-0061
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN215726363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner