Provider Demographics
NPI:1518570365
Name:OGLESBY, TASHA RENEE (BSN,RN)
Entity Type:Individual
Prefix:MS
First Name:TASHA
Middle Name:RENEE
Last Name:OGLESBY
Suffix:
Gender:F
Credentials:BSN,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 CRAIG DR APT 1938
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-4518
Mailing Address - Country:US
Mailing Address - Phone:210-801-0360
Mailing Address - Fax:
Practice Address - Street 1:3400 CRAIG DR APT 1938
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-4518
Practice Address - Country:US
Practice Address - Phone:210-801-0360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-30
Last Update Date:2020-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX766428163WP0200X, 163WP0807X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No163WP0200XNursing Service ProvidersRegistered NursePediatricsGroup - Single Specialty
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent