Provider Demographics
NPI:1508946781
Name:OGLE, SUSAN K (MSN, CRNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:K
Last Name:OGLE
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 CHINABERRY DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444
Mailing Address - Country:US
Mailing Address - Phone:610-828-5360
Mailing Address - Fax:215-590-3296
Practice Address - Street 1:34TH & CIVIC CENTER BLVD.
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-590-4558
Practice Address - Fax:215-590-3296
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP006025N163W00000X
PA002569163WP0218X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WP0218XNursing Service ProvidersRegistered NursePediatric Oncology