Provider Demographics
NPI:1194267369
Name:OGLESBY, SALENA
Entity type:Individual
Prefix:
First Name:SALENA
Middle Name:
Last Name:OGLESBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27400 SIDNEY DR
Mailing Address - Street 2:155
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44132-2976
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:27400 SIDNEY DR
Practice Address - Street 2:155
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44132-2976
Practice Address - Country:US
Practice Address - Phone:216-346-5709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH430971163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse