Provider Demographics
NPI:1609017797
Name:OGLESBEE, KATHRYN (RN)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:OGLESBEE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 WOODMAN DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45420-1143
Mailing Address - Country:US
Mailing Address - Phone:937-298-4417
Mailing Address - Fax:937-298-8260
Practice Address - Street 1:3205 WOODMAN DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45420-1143
Practice Address - Country:US
Practice Address - Phone:937-298-4417
Practice Address - Fax:937-298-8260
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH204117163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse