Provider Demographics
NPI:1215619515
Name:OGLE, CASSIE LYNN (RN)
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:LYNN
Last Name:OGLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12860 MAHAN RD
Mailing Address - Street 2:
Mailing Address - City:SAINT PARIS
Mailing Address - State:OH
Mailing Address - Zip Code:43072-9735
Mailing Address - Country:US
Mailing Address - Phone:937-765-0741
Mailing Address - Fax:
Practice Address - Street 1:12860 MAHAN RD
Practice Address - Street 2:
Practice Address - City:SAINT PARIS
Practice Address - State:OH
Practice Address - Zip Code:43072-9735
Practice Address - Country:US
Practice Address - Phone:937-765-0741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH413926163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn