Provider Demographics
NPI:1972532612
Name:OSAGHAE, ESOHE (MSN, RN-BC, CCM)
Entity type:Individual
Prefix:
First Name:ESOHE
Middle Name:
Last Name:OSAGHAE
Suffix:
Gender:F
Credentials:MSN, RN-BC, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 POINTER RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7405
Mailing Address - Country:US
Mailing Address - Phone:877-875-4370
Mailing Address - Fax:678-870-5111
Practice Address - Street 1:185 POINTER RIDGE TRL
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7405
Practice Address - Country:US
Practice Address - Phone:877-875-4370
Practice Address - Fax:678-870-5111
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN167238163WC1500X, 163WP0808X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health