Provider Demographics
NPI:1780334177
Name:OGLES, JACQUALINE KAY
Entity type:Individual
Prefix:
First Name:JACQUALINE
Middle Name:KAY
Last Name:OGLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6085 SEBRING WARNER RD N LOT 34
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-1678
Mailing Address - Country:US
Mailing Address - Phone:937-569-9391
Mailing Address - Fax:
Practice Address - Street 1:6085 SEBRING WARNER RD N LOT 34
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-1678
Practice Address - Country:US
Practice Address - Phone:937-569-9391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider