Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | AP137195 | TX |
Y | 363LA2100X | Nurse Practitioner - Acute Care | APRN11016195 | FL |
NPI | 1003312042 |
---|---|
Provider Name | Destinee Renee Ogea |
First Address | Venice, FL 34293-2232 |
Second Address | Venice, FL 34293-2232 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2018 |
Last Update Date | 02/11/2021 |