Provider Demographics
NPI:1801282116
Name:OGLESBY-MCCOWAN, KIMBERLY ANN (FNP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:OGLESBY-MCCOWAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:ANN
Other - Last Name:OGLESBY-MCCOWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:4240 HARBOUR ISLAND LANE
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93035
Mailing Address - Country:US
Mailing Address - Phone:805-797-3599
Mailing Address - Fax:
Practice Address - Street 1:1901 OUTLET CENTER DR
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-0663
Practice Address - Country:US
Practice Address - Phone:805-981-8300
Practice Address - Fax:805-981-8302
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95002183363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily