Provider Demographics
NPI:1477137271
Name:OGDEN, GARLAND SIMON (APRN)
Entity Type:Individual
Prefix:
First Name:GARLAND
Middle Name:SIMON
Last Name:OGDEN
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 BROWN THRASHER LOOP N
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-3052
Mailing Address - Country:US
Mailing Address - Phone:985-373-8878
Mailing Address - Fax:
Practice Address - Street 1:1520 LA-22
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70403-1478
Practice Address - Country:US
Practice Address - Phone:985-898-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA218935363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner