Provider Demographics
NPI:1972127009
Name:OGLESBY, GLYNDA DON (RN)
Entity type:Individual
Prefix:
First Name:GLYNDA
Middle Name:DON
Last Name:OGLESBY
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 1:221 STATE HIGHWAY 110
Mailing Address - Street 2:
Mailing Address - City:GRAND SALINE
Mailing Address - State:TX
Mailing Address - Zip Code:75140-5081
Mailing Address - Country:US
Mailing Address - Phone:830-385-5440
Mailing Address - Fax:
Practice Address - Street 1:221 STATE HIGHWAY 110
Practice Address - Street 2:
Practice Address - City:GRAND SALINE
Practice Address - State:TX
Practice Address - Zip Code:75140-5081
Practice Address - Country:US
Practice Address - Phone:830-385-5440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX820129163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse