Provider Demographics
NPI:1407276603
Name:OLOGN, NDIDI
Entity Type:Individual
Prefix:
First Name:NDIDI
Middle Name:
Last Name:OLOGN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5161 HAMPSTED VILLAGE CENTER WAY
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-8329
Mailing Address - Country:US
Mailing Address - Phone:614-000-0000
Mailing Address - Fax:
Practice Address - Street 1:5161 HAMPSTED VILLAGE CENTER WAY
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-8329
Practice Address - Country:US
Practice Address - Phone:614-000-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-26
Last Update Date:2015-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000000164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse