Provider Demographics
NPI:1588461503
Name:OGUMERE, DENISHA
Entity type:Individual
Prefix:
First Name:DENISHA
Middle Name:
Last Name:OGUMERE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4831 ANTIOCH BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-2328
Mailing Address - Country:US
Mailing Address - Phone:225-512-7500
Mailing Address - Fax:
Practice Address - Street 1:4831 ANTIOCH BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-2328
Practice Address - Country:US
Practice Address - Phone:225-512-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator