Provider Demographics
NPI:1386918464
Name:OGDEN, KIERSTEN MCLEOD (DC)
Entity type:Individual
Prefix:DR
First Name:KIERSTEN
Middle Name:MCLEOD
Last Name:OGDEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 4TH N ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-2127
Mailing Address - Country:US
Mailing Address - Phone:727-823-3151
Mailing Address - Fax:727-821-2419
Practice Address - Street 1:3200 4TH N ST
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-2127
Practice Address - Country:US
Practice Address - Phone:727-823-3151
Practice Address - Fax:727-821-2419
Is Sole Proprietor?:No
Enumeration Date:2012-03-07
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10759111N00000X
FLCH 10759111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGX726AMedicare Oscar/Certification