Provider Demographics
NPI:1144499914
Name:OGDEN, ALICE JOANN (MSN, APRN-BC,ANP)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:JOANN
Last Name:OGDEN
Suffix:
Gender:F
Credentials:MSN, APRN-BC,ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 HERRING AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76708-3245
Mailing Address - Country:US
Mailing Address - Phone:254-755-4582
Mailing Address - Fax:254-755-4585
Practice Address - Street 1:2911 HERRING AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-3245
Practice Address - Country:US
Practice Address - Phone:254-755-4582
Practice Address - Fax:254-755-4585
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225777363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX225777OtherAPRN LICENSE
TX225777OtherRN LICENSE
TXG0156790OtherDPS LICENSE