Provider Demographics
NPI:1629367115
Name:OGBU, JESSY RITA (RN)
Entity Type:Individual
Prefix:
First Name:JESSY
Middle Name:RITA
Last Name:OGBU
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 1:2851 BRONCO DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3225
Mailing Address - Country:US
Mailing Address - Phone:469-735-6843
Mailing Address - Fax:972-572-0009
Practice Address - Street 1:2851 BRONCO DR
Practice Address - Street 2:SAME
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3225
Practice Address - Country:US
Practice Address - Phone:469-735-6843
Practice Address - Fax:972-572-0009
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health