Provider Demographics
NPI:1912027525
Name:OGLES, ELISABETH B (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ELISABETH
Middle Name:B
Last Name:OGLES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86261 HWY. 9
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:AL
Mailing Address - Zip Code:36251-1500
Mailing Address - Country:US
Mailing Address - Phone:256-354-5064
Mailing Address - Fax:256-354-7099
Practice Address - Street 1:83745 HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:AL
Practice Address - Zip Code:36251-1500
Practice Address - Country:US
Practice Address - Phone:256-354-5064
Practice Address - Fax:256-354-7099
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-075324363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALS62621Medicare UPIN