Provider Demographics
NPI:1053558403
Name:OGBURN, RHONDA DENISE
Entity type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:DENISE
Last Name:OGBURN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CASH RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37334-4845
Mailing Address - Country:US
Mailing Address - Phone:931-937-6861
Mailing Address - Fax:
Practice Address - Street 1:615 MAPLE ST W
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37334-3303
Practice Address - Country:US
Practice Address - Phone:931-438-4993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker