Provider Demographics
NPI:1619424207
Name:OGUNSILE, VIRGINIA DANETTE (RN)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:DANETTE
Last Name:OGUNSILE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:DANETTE
Other - Last Name:BRIMINGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7301 N 58TH AVENUE
Mailing Address - Street 2:GLENDALE ELEMENTARY DISTRICT 40
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-1893
Mailing Address - Country:US
Mailing Address - Phone:623-237-7223
Mailing Address - Fax:
Practice Address - Street 1:7301 N 58TH AVENUE
Practice Address - Street 2:GLENDALE ELEMENTARY DISTRICT 40
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-1893
Practice Address - Country:US
Practice Address - Phone:623-237-7223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN075368163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse