1669671012 NPI number — MS. JINGA LONEE OGLESBY-BRIHM DNP, APRN, ANP-C

Table of content: MS. JINGA LONEE OGLESBY-BRIHM DNP, APRN, ANP-C (NPI 1669671012)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669671012 NPI number — MS. JINGA LONEE OGLESBY-BRIHM DNP, APRN, ANP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OGLESBY-BRIHM
Provider First Name:
JINGA
Provider Middle Name:
LONEE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
DNP, APRN, ANP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669671012
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2430 WELLINGTON GREEN DR APT 209
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WELLINGTON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33414-9319
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-905-9757
Provider Business Mailing Address Fax Number:
561-437-8276

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
491 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PAHOKEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33476-1811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-867-7850
Provider Business Practice Location Address Fax Number:
561-437-8276
Provider Enumeration Date:
07/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  ARNP9196700 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 115687500 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com