Provider Demographics
NPI:1295820892
Name:OGDEN, PAMELA A (NP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:OGDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1200 E MICHIGAN AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-1899
Mailing Address - Country:US
Mailing Address - Phone:517-484-4033
Mailing Address - Fax:517-484-2701
Practice Address - Street 1:1200 E MICHIGAN AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1899
Practice Address - Country:US
Practice Address - Phone:517-484-4033
Practice Address - Fax:517-484-2701
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704152512363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIS82420Medicare UPIN