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Individual
MRS. JENNIFER LYNN OGLE
Active
Individual
MRS. JENNIFER LYNN OGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04276
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962467068
BLUE CROSS BLUE SHIELD
TX
05
—
323920401
—
TX
05
—
323920402
—
TX
05
—
323920405
—
TX
01
—
601771109
US DEPT OF LABOR
—
01
—
616771101
US DEPT OF LABOR
—
01
—
616771105
US DEPT OF LABOR
—
01
—
616771110
US DEPT OF LABOR
—
01
—
8409ND
BLUE CROSS BLUE SHIELD
TX
01
—
P01258234
MEDICARE RR
TX
Enumeration date
04/20/2006
Last updated
10/08/2018
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