Provider Demographics
NPI:1922178078
Name:OGDEN, KATHLEEN A (MD)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:A
Last Name:OGDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8761 WEST CENTER RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2109
Mailing Address - Country:US
Mailing Address - Phone:402-397-6060
Mailing Address - Fax:402-398-0336
Practice Address - Street 1:8761 WEST CENTER RD
Practice Address - Street 2:SUITE B
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2109
Practice Address - Country:US
Practice Address - Phone:402-397-6060
Practice Address - Fax:402-398-0336
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE18975207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE279022Medicare ID - Type Unspecified
F82228Medicare UPIN