Individual
TIFFANY DAWN OGG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
53 E WALWORTH AVE, DELAVAN, WI 53115-1115
(262) 728-1428
Mailing address
53 E WALWORTH AVE, DELAVAN, WI 53115-1115
(262) 728-1428
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38257900
—
WI
Enumeration date
03/21/2006
Last updated
07/08/2007
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