Provider Demographics
NPI:1861151243
Name:OGDEN, ERIN (RD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:OGDEN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 ESTHER CT
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-8115
Mailing Address - Country:US
Mailing Address - Phone:253-486-6296
Mailing Address - Fax:
Practice Address - Street 1:809 ESTHER CT
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-8115
Practice Address - Country:US
Practice Address - Phone:253-486-6296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-13
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10464096-4901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered